Southern Baptist Disaster Relief · 2019. 5. 23. · In parallel development, the American Red Cross formally began deploying the Spiritual Care Aviation Incident Response Team (now

Southern Baptist

Disaster Relief

Chaplain Training

Manual

December 2016

North American Mission Board, SBC

Revised version 2016 Page ii

Table of Contents

Objectives

UNIT 1

UNIQUENESS OF CRISIS MINISTRY IN DISASTERS ......................................................... 1

Introduction: History of Crisis Ministry ............................................................................. 1 What Is So Unique About a Chaplain in Disaster? ............................................................. 2

Spiritual Rationale for Chaplains in Disasters .................................................................... 5

Demonstrating Compassion is Being Present in Suffering ....................................... 5

Demonstrating Compassion is Being Sensitive to Human Diversity ........................ 7

Demonstrating Compassion is Providing the Ministry of Care in Crisis ................. 8

Ministry Tasks of the Chaplain in Disasters ..................................................................... 10

Differences Between Chaplains in Disasters and Community Clergy .............................. 11

UNIT 2

OVERVIEW OF THE CRISIS RESPONSE ............................................................................. 14

Understanding the Terminology and Concepts ................................................................. 14

What Constitutes a Disaster? ............................................................................................ 16

Types of Disasters ............................................................................................................. 17

What Happens During A Community Disaster? ............................................................... 17

Who, What, When, Where, Why, and How of Crisis Response ....................................... 19

Victim Classifications .............................................................................................. 20

Emerging Issues for People and Groups Involved in Disasters .............................. 20

UNIT 3

HUMAN NEEDS AND DEVELOPMENT ................................................................................ 22

Maslow’s Hierarchy of Needs—Identifying the Crisis ..................................................... 22

Physiological Needs ................................................................................................ 22

Safety and Security Needs ....................................................................................... 22

Belonging and Social Affiliation Needs .................................................................. 23

Self-Esteem Needs ................................................................................................... 23

Self-Actualization Needs ......................................................................................... 23

Identifying the Crisis ............................................................................................... 24

Stages of Human Development—The Age-Specific Human Response to Crisis ............. 25

Conclusions and Applications ................................................................................. 27

Eight Stages of Life Chart for Crisis Intervention .................................................. 29

UNIT 4

OVERVIEW OF THE TRAUMA RESPONSE ........................................................................ 30

Distress as the Trauma Response ...................................................................................... 30 The Nature of Stress ................................................................................................ 30

The Internal Trauma Response ............................................................................... 30

Biological Factors—Physical Response ........................................................................... 32

Psychological Factors—Mental Response ........................................................................ 32

Social Factors—Relational Response ............................................................................... 34

Behavioral Factors—Action Response ............................................................................. 34

Spiritual Factors—Faith Response ................................................................................... 34

Crisis Intervention as a Response to Trauma .................................................................... 35 Stress Symptoms Chart ..................................................................................................... 36


UNIT 5

THE ART OF STORY-LISTENING ......................................................................................... 37

Differences Between Hearing and Listening .................................................................... 37

Ethics of Listening ............................................................................................................ 37

Ministry of Presence ......................................................................................................... 38

Ministry of Silence ............................................................................................................ 38

Improving Listening Skills ................................................................................................ 39

Clarify ..................................................................................................................... 39

Paraphrase .............................................................................................................. 39

Summarize ............................................................................................................... 40

Echo ........................................................................................................................ 40

Reflect ...................................................................................................................... 40

UNIT 6

CRISIS INTERVENTION MODELS ........................................................................................ 41

Crisis Intervention ............................................................................................................. 41 International Critical Incident Stress Foundation (ICISF) ................................................ 43

Effective Disaster Relief Includes Trained Chaplains as Part of the ................................. 43

Interdisciplinary Team in Disasters and Other Emergencies Summary ........................................................................................................................... 45

UNIT 7

COMPASSION IN CRISIS ......................................................................................................... 46

Demonstrating Compassion is Being Present in Suffering ............................................... 46 Demonstrating Compassion is Being Sensitive to Human Diversity. ............................... 47

Demonstrating Compassion is Providing the Ministry of Care in Crisis .......................... 48

Compassion at the Scene................................................................................................... 49

What to Be ............................................................................................................... 49

What to Have ........................................................................................................... 49

What to Say ............................................................................................................. 50

What to Do .............................................................................................................. 51

Compassion Fatigue .......................................................................................................... 51

Reactions to Long-term Stress ................................................................................. 51

Signs and Symptoms of Compassion Fatigue .......................................................... 54 Basic Self-Care ................................................................................................................. 54

UNIT 8

COMFORTING GRIEF IN DISASTERS ................................................................................. 56

Elements of Grief .............................................................................................................. 56 Defining Grief ......................................................................................................... 56

A Picture of Grief .................................................................................................... 56

Losses that Lead to Grief ........................................................................................ 57

Grief Is a Process .............................................................................................................. 58

Comforting Grief .............................................................................................................. 61

Complicated Mourning ..................................................................................................... 61

Lesson Learned ................................................................................................................. 62

UNIT 9

SPIRITUAL DIMENSIONS OF TRAUMA .............................................................................. 64

Overview of Spirituality in Trauma .................................................................................. 64

Role of Religion and Spirituality ...................................................................................... 65


Spiritual Issues and Questions from Victims and Survivors ............................................. 66

Religious Coping Styles .................................................................................................... 67

Spiritual Interventions for Disasters.................................................................................. 68

Red Flags for Disaster Chaplain Interventions ................................................................. 69

Ethics of Chaplain Interventions in Disasters ................................................................... 69

What Victims Want to Say to Disaster Chaplains ............................................................. 70

Conclusion ........................................................................................................................ 71

UNIT 10

MINISTERING IN THE MIDST OF DIVERSITY ................................................................. 72

Contextualized Ministry is Cross-Culturally Competent .................................................. 72

Intentional Cultural Diversity Creates Multiple Needs ........................................... 72

Cultural Perspective Affect Trauma and Recovery ................................................. 72

Demonstrating Respect for Cultural Differences .................................................... 73

Maintaining Personal Faith .................................................................................... 74

“Red Flags” for Chaplains in Diversity ............................................................................ 74

“Relief” for the Chaplain in the Context of Cultural and Religious Diversity .................. 74

Principles for Ministering in Diversity ............................................................................. 75

Chaplains Must Recognize the “UNKNOWN GOD” in Diversity ................................... 76

Clarifying Cultural Needs ................................................................................................. 77

Summary ........................................................................................................................... 77

Chart: Common Religious and Cultural Customs Concerning Death ............................... 78

UNIT 11

WHAT TO DO NEXT ................................................................................................................. 79

Pre-Training Requirements ............................................................................................... 79

Training Requirements ...................................................................................................... 79

Additional Training & Education ...................................................................................... 80

UNIT 12

RESOURCES FOR DISASTER RELIEF CHAPLAINS ......................................................... 81

Agencies ............................................................................................................................ 81

Professional Organizations ............................................................................................... 82

Community ....................................................................................................................... 83

Literature and Music ......................................................................................................... 83

Contacts ............................................................................................................................ 83

Endnotes ......................................................................................................................................... 84

Appendix….....................................................................................................................................89

2004, 2007 North American Mission Board of the Southern Baptist Convention, Alpharetta, Georgia.

All rights reserved.

Topic Unit objective

Unit 1 Uniqueness of Crisis Ministry in Disasters Know the difference between being a church pastor and a community

chaplain in disaster relief

Unit 2 Overview of the Crisis Response Understand the basics of crisis response – what’s crisis, who are the victims, who are the caregivers, when to respond,

whose lead to follow

Unit 3 Human Needs and Development Understand how to determine what the basic human need is

during crisis intervention and how to respond with the correct

intervention

Unit 4 Overview of the Trauma Response Understand holistically what happens to a victim during a crisis

Unit 5 The Art of Story-Listening Know the difference between listening and hearing

Understanding confidentiality, presence, silence

Understand the art of story-listening

Unit 6 Crisis Intervention Models Be aware of different crisis intervention models

CISM, OSFA

Unit 7 Compassion in Disaster Crisis Understand the ministry of compassion Understand how to demonstrate compassion at the scene

Recognize the symptoms of compassion fatigue and how to do self-

care

Unit 8 Comforting Grief in Disasters Understand the basics of grief and loss

Understand the expressions of loss

Know how to comfort grief

Unit 9 The Spiritual Dimensions of Trauma Understand the role of religion and spirituality in crisis intervention

Understand the basic spiritual issues of victims and survivors

Know some basic crisis interventions

Unit 10 Ministering in the Midst of Diversity Understand the basics of cultural and religious diversity

Understanding the principles for ministering in diversity

Unit 11 What to Do Next Pre-training requirements

Training requirements

Additional training & education

Unit 12 Resources for Disaster Relief Chaplains Know how to get basic resources for referrals

Know who to contact for resourcing help

Have a detailed bibliography for books, articles, and internet

resources

Revised version 2016

Revised version 2016 Page 1

UNIQUENESS OF CRISIS MINISTRY IN DISASTERS

UNIT 1

Introduction: History of Crisis Ministry1

The development of chaplain ministry has its roots in ancient history.

Religious men and women often accompanied armies into battle as priests.

From the settlement of Canaan through the period of the judges, spiritual leaders

provided encouragement and compassionate care to people who were constantly

in crisis. Chaplains sailed with Sir Francis Drake in the sixteenth century and

fought with Washington during the Revolutionary War. They prayed through

human suffering, encouraged in despair, and officiated over ceremonial events.

They have counseled and consulted for kings, parliaments, and governments—

for the incarcerated, the sick, and the disenfranchised.

Today, chaplains are found in many settings—military, healthcare, law

enforcement, institutions, business and industry, resorts, racetracks, gambling

casinos, job corps, shelters, rescue missions, professional sports teams, factories,

and corporations. Placement is limited only by the lack of imagination.

The word “chaplain” originates in fourth-century France. A traditional

story relates the compassion of St. Martin of Tours. One cold and wet night, he

was so moved by compassion for a beggar, he shared his cloak. Upon his death,

his cape (capella in Latin) was preserved as a holy relic and kept in a shrine that

came to be known as chapele from which the English word chapel is derived.

The guardian of the chapele became known as the chapelain. Today, the

chaplain continues to guard the sacred and to share his cape out of compassion.

One growing specialization in chaplain ministry is disaster relief

chaplaincy. Military chaplains, hospital chaplains, law enforcement chaplains,

and others have often ministered during difficult crises and emergencies, but the

disaster relief specialization has emerged during the past 15 years, albeit

informally. Most chaplains respond to the crises within their own organizations

(the Army, the hospital, the police department), but many respond to the general

community during community emergencies. Disaster relief chaplains often serve

multiple agencies and usually respond to the general community of victims

during the crisis. Victims may include innocent bystanders, direct victims,

rescue and relief workers, and even the perpetrator of crimes (the arsonist who

starts the forest fire, the drunk driver who causes the multi-car fatality, or the

terrorist who plants the bomb).

In the past, professional chaplains from many arenas of service have

responded to major disasters; however, many have not been trained for the

unique needs and issues that surround emergency disaster care. With greater

awareness for the value of spiritual care in conjunction with physical care during

emergencies, the disaster relief chaplain specialization has evolved into a major

chaplain category.

Chaplains have provided compassionate care throughout history

Chaplains guard what is sacred in people’s lives

Disaster relief chaplaincy is a specialized form of chaplain ministry


The Southern Baptist Disaster Relief organization, the most highly

recognized denominational disaster relief assemblage of many autonomous state

groups, has cooperated with the American Red Cross in developing effective

disaster relief services, including chaplains who provide spiritual care. Mickey

Caison, former national director for Southern Baptist Disaster Relief, reports that

chaplains have provided ministry during many Southern Baptist Disaster Relief

efforts following tornadoes (1996, 1997, 2007), hurricanes (1989, 1992, 2005),

floods (1997, 2007), wildfires (2007), and terrorism (1995, 2001).

In parallel development, the American Red Cross formally began deploying

the Spiritual Care Aviation Incident Response Team (now called Spiritual

Response Team – SRT) disaster relief chaplain teams to airline disasters on June

1, 1999, upon the crash of American Airlines Flight 1420 in Little Rock, Ark.

Today the SRT deploys to many mass casualty incidents with Red Cross trained

volunteers. Furthermore, since the advent of formalized chaplaincy

organizations, including the International Conference of Police Chaplains in

1973 and the Federation of Fire Chaplains in 1978, emergency response agencies

have used their departmental chaplains during disasters to minister to their own

personnel.

The growing awareness of spiritual needs in crisis has begun to formalize

the response of disaster relief chaplains. National and international disaster

relief agencies are beginning to work together to coordinate spiritual care

response in disasters of many kinds. With technological advances and the

globalization of America, relief agencies have recognized the need to redefine

the arena of disasters. It is no longer only the site/location directly impacted by

the disaster, but now includes remote locations, institutions, and people groups

who are in some way related or impacted by the disaster (e.g., the departure and

arrival airports, the out-of-state corporate headquarters, the home church of the

children in the bus, the manufacturer and factory of the faulty electrical switch).

The need for spiritual and emotional support far exceeds the disaster location,

hospital, or disaster shelter.

Southern Baptists are recognized disaster relief caregivers

What Is So Unique About a Chaplain in Disasters?

The definition of spiritual care is derived from the biblical image of the

shepherd who cares for a flock. In a very broad and inclusive way, spiritual care

incorporates all ministries that are concerned with the care and nurturing of

people and their relationships within a community. This could include the

classic approaches—interpretation, prayer, meditation—or some of the more

contemporary approaches that have been influenced by training bodies such as

the American Association of Pastoral Counselors and the Association of

Professional Chaplains—presence, listening, and reflection. In disasters,

spiritual care is often pictured as providing a calm presence, nonjudgmental

listening, caring interventions, and the hope one can have through faith in Jesus

Christ.

Disaster relief chaplains come from a variety of professions and ministries.

They may be pastors, chaplains, counselors, teachers, social workers, or

Spiritual care is leading, guiding, nurturing, sustaining, healing, and restoring

Chaplains include pastors and laity


psychologists. Disaster relief chaplains may also be laity—men and women who

respond to God’s call upon their lives to provide care and compassion to hurting

people during the crisis of disasters.

Who are some chaplains you have known?

Disasters are critical events and critical events often cause crisis for those

who are involved. The American Red Cross reports that 59 percent of

Americans would be likely to seek counsel from a spiritual care provider in such

circumstances.2 Chaplains need to utilize their particular role and skills in an

intentional manner to enhance the coping capabilities and spiritual reactions to a

disaster. Providing spiritual care in the wake of disasters often involves

integrating spiritual responses with other kinds of help provided by emergency

care responders, mental health providers, and social care agents. Such help is

best managed through the framework of established crisis intervention

principles. Spiritual care providers should understand how various

representatives of the other caring components typically operate in consideration

of these principles.

There are organizations that provide significant settings for understanding

how to integrate spiritual care with other care efforts during a crisis. One is The

International Critical Incident Stress Foundation (ICISF) This organization has

well-established methodologies for crisis intervention and can assist chaplains in

becoming more informed about how to interact with other care providers.

Examples of the ICISF model are presented in Unit 6.

One unique aspect of many chaplains serving in disasters is that these

providers are usually pastors or laity; therefore they do not work in a disaster

environment on a routine basis and would not be considered professional disaster

relief personnel. Instead, these chaplains are often volunteers from a variety of

spiritual care settings who participate in training and gain significant disaster

relief experience in order to be prepared for a response when spiritual needs

emerge. These volunteers are usually trained and organized by organizations

like The American Red Cross, The Salvation Army, Billy Graham Evangelistic

Association, and other similar entities. Among Southern Baptists, state Baptist

conventions recruit, train, and deploy chaplains, cooperating together with the

networking leadership of Southern Baptist Disaster Relief when multistate

involvement is needed. All of these entities respond to crisis out of a caring

concern for those suffering injury, loss, or some other form of crisis.

Chaplains in disasters provide caring ministry on the field of disasters,

during and after the disaster occurrence, to any victim of the disaster, for a few

seconds or for a few hours. As these caregivers receive specialized training in

crisis and spiritual interventions, much of the specialized training is built upon

the previous education and experience of the chaplain.

In addition to the ministry of presence, ministry of compassion, and

attentive listening, spiritual caregivers may choose from a number of

intervention methods that are uniquely theirs as people of faith and spirituality

(see pages 68, 69):

Victims seek spiritual care in disaster crises


Scriptural education, insight, reinterpretation

Individual and conjoint prayer

Belief in intercessory prayer

Unifying and explanatory worldviews

Ventilative confession

Faith-based social support systems

Rituals and sacraments

Belief in divine intervention/forgiveness

Belief in a life after death

Unique ethos of the crisis interventionist

Uniquely confidential/privileged communications

What do disaster chaplains do?

1.

2. 3.

How do disaster chaplains get their training/education?

1.

2. 3.

In a few sentences, write a paragraph about why you would like to be a disaster

chaplain.

Why do you want to be a disaster relief chaplain?


Spiritual Rationale for Chaplains in Disasters3

Demonstrating Compassion Is Being Present in Suffering

W. E. Vine defines being moved with compassion as being moved in

one’s inwards (bowels).4 The splanchma are the entrails of the body. Modern

vernacular might translate this as having deep feelings in one’s “gut.” This is the

center of one’s personal feelings and emotions—love and hate—the feelings that

emanate from one’s “heart.” When the Gospels speak of Jesus’ compassion,

they speak of deep, powerful emotions that far exceed the superficial feelings of

regret, distress, or remorse.

The English word compassion comes from two Latin words, cum and

pati, which form the meaning, “suffer with.” It is “. . . a feeling of deep

sympathy and sorrow for another who is stricken by suffering or misfortune,

accompanied by a strong desire to alleviate the pain or remove its cause.”5

“Compassion asks us to go where it hurts, to enter into places of pain, to share in

brokenness, fear, confusion, and anguish. Compassion challenges us to cry out

with those in misery, to mourn with those who are lonely, to weep with those in

tears. Compassion requires us to be weak with the weak, vulnerable with the

vulnerable, and powerless with the powerless. Compassion means full

immersion in the condition of being human.”6 Compassion enters into the

suffering and pain of the one who suffers. It is more honorable than pity and

more courageous than sympathy. Complete empathy for the desolation and grief

of those who are suffering requires compassion.

The disaster relief chaplain must know his or her own biases, needs, and

limitations and still deeply desire to identify with the disenfranchised and the

wounded, seeking to demonstrate the compassion of Christ as the priority of

chaplain ministry. Merely attempting to prevent suffering or not be the cause of

suffering will be inadequate. The disaster relief chaplain must approach ministry

from a radically different paradigm—the chaplain must initiate and be an active

participant in “being” compassion as a priority and “doing” compassion as a

necessity.7 Recognizing one’s own natural instinct to excuse oneself from the

crisis, the chaplain must still choose to become engaged in the suffering. The

significance of being compassionate may lay in the fact that being compassionate

is not an activity one naturally seeks, but an activity that one must intentionally

choose, knowing that it “feels” contrary to natural instincts.

The theological foundation for disaster relief chaplaincy is supported

through the mandate to bear one another’s burdens (see Gal. 6:28); and therefore, “You must be compassionate just as your Father is compassionate” (Luke 6:36, NLT). The cup of cool water and the Good Samaritan also reinforce this imperative.

A vital aspect of disaster chaplaincy is “the ministry of presence.” “A

major premise of care amid crisis is presence. The care of souls first requires

being there. Simple, empathic, listening presence is a primary pastoral act, the

presupposition of all other pastoral acts.”9 The power of this ministry is in its

altruistic service. If chaplains provide compassion by bearing another’s burdens,

then chaplains choose to “suffer with” those who are suffering. Providing

Compassion is felt in one’s “gut”

Compassion enters into the suffering and pain of the one who suffers

Disaster chaplains must intentionally choose a disaster relief ministry

“You must be compassionate just as your Father is compassionate” (Luke 6:36, NLT)

A vital aspect of disaster chaplaincy is the “ministry of presence”


compassion requires stepping out of one’s comfort zone and intentionally

entering a place of crisis—danger, pain, loss, or grief—during the spiritual and

emotional crises of life.

God is present in the suffering

The strength of a caregiving relationship is in the fact that one is never

alone. God is present with the chaplain. The presence of God within the

ministry situation empowers the chaplain to provide effective, appropriate

spiritual support within the context of disaster.

Henri Nouwen calls the incarnation of God the “divine solidarity.” It is the

compassionate God who chooses to be God-with-us. The chaplain in disasters

often represents the presence of God.

“The heroes of the faith had one thing in common: They were all ordinary

people with no power of their own. The difference is the mighty presence of

God. Times may change, but the effect of God’s presence remains the same.”10

Chaplains who enter into the suffering and chaos of crisis are empowered by the

same presence of God to give them victory over despair, loss, and insufficiency.

The chaplain in disasters shares God’s presence with victims and offers

the same words of assurance—“I am with you.” The chaplain cannot deny the

reality of the crisis, should not minimize the sense of loss it causes, and may not

be able to diminish any of the pain. But, the chaplain offers the comfort of

God’s presence through words of comfort and assurance. Presence may invite a

sense of community within the crisis, may lead to healing reconciliation, or may

reconnect a disenfranchised person with God.

What evidence do you have of God’s presence in suffering?

What does your theology teach you?

1.

2. 3.

What have you witnessed?

1.

2. 3.

What have you experienced?

1.

2. 3.

How could a disaster victim benefit from your “ministry of presence?”

In 1893, Francis Thompson portrayed God’s presence as the “Hound of Heaven.” No matter where he fled, no matter where he hid, there was no escaping God’s presence. God is “that tremendous lover, pursuing me with his love.”25

“I am with you”


Practicing God’s presence in suffering

The chaplain in disasters demonstrates compassion by being present in

suffering. Sometimes like a “wounded healer,” he or she sits among the

wounded to bind and unbind his or her own wounds slowly and carefully so that

he will be able to immediately respond to bear the burden of another who is

suffering.11 The chaplain in disasters practices the presence of God through

prayer, listening, the spoken word, the Holy Scriptures, and service. In the

moment of crisis, many who are suffering desire an advocate who will plead

their case before God, and in the prayer, they find comfort and assurance that

God hears their plea.12 During the crisis, victims need to tell their stories and

need to have validation of their feelings and sense of loss. Here the chaplain in

disasters practices the presence of God in active listening and the spoken word.

Often the crisis requires acts of service. Practicing the presence of God is

experienced in feeding the hungry, giving a drink to the thirsty, showing

hospitality to strangers, clothing the naked, and visiting the sick (see Matt.

25:35-40). In the aftermath of crisis, worship or remembrance may bring healing

and new understanding to the intense suffering and acute pain of loss.

“Presence” is one of the most powerful acts of ministry a chaplain in

disasters can provide. Demonstrating compassion by physical and spiritual

presence is the beginning of the relationship that brings comfort and healing. In

many cultures, establishing and reestablishing the relationship by physical

presence is primary to even general conversation.13 When words have no

relevance and actions have no meaning, the Emmanuel—God with us—suffering

with the victim may be the most potent act of the chaplain in disasters.

Demonstrating Compassion is Being Sensitive to Human Diversity

There is tension in balancing cultural acceptance and uncompromising

convictions. With the deteriorating influence of the church in culture14 and the globalization of society, the tension rises for people of deep faith and

convictions.15 As globalization increases, cultural diversity increases.

We live in a multicultural society that is very diverse, but chaplains must

not hesitate to demonstrate compassion by ministry action. They must actively

search out those in crisis, making no distinction of race, gender, religion, or

economic status. Their actions must speak of kindness and mercy borne out of

compassion for all people.

Most of us sense the ability of people to respond to the needs of those less

fortunate, but what of the more fortunate—those of higher position, status, or

social class? Human diversity includes the rich and famous. Neither political

alignment nor religious position must prevent the chaplains in disasters from

providing compassionate ministry action. Chaplains in disasters may even be

called upon to minister to those whose political or religious prominence may be

intimidating or abhorrent.

Chaplains in disasters, too, may be called upon to offer caring ministry to

the outcasts of society—the homeless, the addicted, the incarcerated, the

The chaplain in disasters practices the presence of God through prayer, listening, the spoken word, the Holy Scriptures, and service

Chaplains in disasters provide the “ministry of presence”

Cultural diversity has increased

Chaplains in disasters must demonstrate compassion for all people

Chaplains in disasters may even be called upon to minister to those whose political or religious prominence may be intimidating or abhorrent

Sensitivity to human diversity means doing ministry with the disenfranchised of society


“leper.”16 Sensitivity to human diversity means doing ministry with the

disenfranchised of society.

One of the challenges chaplains in disasters will certainly face is a ministry

encounter with people who do not come directly under their usual sphere of

responsibility—the victims may not be patients in their hospital or members of

their church. Here the chaplain in disasters assumes the “anyway” attitude of

providing care, crossing the barrier of assumed responsibility, and ministering to

victims “anyway.”

Demonstrating Compassion Is Providing the Ministry of Care in Crisis

Doing practical acts of ministry care is perhaps the most obvious

demonstration of compassion. Most chaplains who enter the disaster relief

ministry desire to “help” those in need. “Help” is the active verb which means to

give assistance or support, to make more bearable, to give relief, to change for

the better, or to serve with food or drink.17 Often the “help” is presence and

encouragement; but equally often it is the action of “helping” by the practical

acts of giving something to eat or drink, providing shelter or clothing, looking

after, and doing deeds of kindness (see Matt. 25:34-40).

By assuming the attitude of the servant

For the chaplain in disasters, providing the ministry of care in crisis must

arise from the servant’s heart. The chaplain may be a person of authority, a

person of resources, or a person of prominence; but his or her response must

grow out of the attitude of a servant. The chaplain must demonstrate compassion

in servanthood in the same way Jesus fully identified Himself with humanity in

His incarnation, giving up privileged position, heavenly wealth, and divine

independence.

Robert Greenleaf says that the best test of this servant attitude is: “Do those

served grow as people? Do they, while being served, become healthier [has their

level of stress been mitigated?], wiser [have the circumstances been clarified?],

freer, more autonomous [more able to cope with the crisis or disaster?], more

likely themselves to become servants? And, what is the effect on the least

privileged in society [the direct victims of disaster]; will they benefit [was there

compassion demonstrated in ministry action?], or, at least, not be further

deprived?”18

By providing encouragement

In crisis and disasters, people often respond in fear, confusion, or anxiety

over such issues as their vulnerability, their grief, and their loss of trust in the

natural order of life. A significant demonstration of compassion in the ministry

of care in crisis is providing encouragement through words and actions.

“Anyway” ministry

Compassion is demonstrated in doing practical acts of ministry

Have a servant heart

“Servanthood,” not “servitude”

People in crisis need encouragement


The chaplain in disasters must be able to convey encouragement to a soul

that is despairing by saying, “Take courage! It is I. Don’t be afraid” (Mark 6:51).

In the midst of the storms of life—the disasters, the crisis, and the devastation—

the chaplain must bring the assurance of hope. Victims may not understand and

they may be “astonished,” but they will experience the compassionate

encouragement of the chaplain.

Victims of disasters “tend to feel anxious and upset because of their

apparent helplessness to deal with the situation. A crisis may erupt when a

person is faced with a problem that calls on resources or problem-solving

abilities that have not previously been needed. In other words, they lack

experience in dealing with the situation.”19 In situations such as this, the

chaplain in disasters provides encouragement by listening, dialoguing,

comforting, and clarifying. In the crisis and confusion, the chaplain provides

active listening to hear the fears, frustrations, and disappointment. He or she

engages in dialogue as he or she asks probing questions for self-examination and

reflection. He or she comforts in the silent spaces. He or she clarifies by

examining circumstances and options; then, he or she releases the victims,

empowered to move forward in spiritual and physical healing.

By meeting immediate needs

When chaplains step onto the disaster site, their reaction is often, “What can

I do?” They want to meet the immediate needs of victims. While “being”

present in the suffering of disaster victims and demonstrating sensitivity to

human diversity are essential, chaplains also have a deep desire to meet

immediate needs. Chaplains often join with disaster relief teams to provide food

to the hungry, water to the thirsty, medical care to the injured, shelter for the

homeless, and clothing to the exposed. They meet the immediate needs of

assistance in searches, rescues, and victim assessments.

By offering prayer

“There are no atheists in foxholes,” reads the bumper sticker. In crisis, even

the non-religious person often cries out in desperate prayer, “Oh, God!” In the

crisis of disasters and devastation, victims often ask for the ministry of prayer.

Christians believe that when “we do not know how to pray as we should,… the

Spirit Himself intercedes for us with groanings too deep for words” (Rom. 8:26,

NASB). The victim of disaster often sees the chaplain as God’s representative

and desires “a word of prayer.” In anxious moments, there is peace in prayer,

and chaplains offer the ministry of care through prayer. When chaplains pray for

victims, they must remember three things: “First, whenever we long for and pray

for the well-being of other people, we are only asking of God what God already

longs for far more than we. Second, if we are to be friends of God, we must tell

God what we want for others as surely as we must ask God for ourselves,

without worrying about the appropriateness of our asking or the probability that

what we ask for we will receive. . . . Third, where it is possible, if our prayers are

to be true acts of friendship, we must not only pray for others, we must act in

accordance with our own prayer.”20

Chaplains bring the assurance of hope

The chaplain in disasters releases the empowered victims to move forward in spiritual and physical healing

Disaster chaplains have a desire to meet immediate needs

“There are no atheists in foxholes”


By leading others to Christ

When disaster relief chaplains are able to demonstrate compassion by

providing the ministry of care in crisis, they also encounter many opportunities

to share the “Good News.” When victims perceive losses that overwhelm their

coping abilities, they often ask, “How do you get through crisis, Chaplain?” Here

is the opportunity to share an appropriate testimony of the power of Christ in us.

Here is the opportunity to offer the hope of salvation. Here is the opportunity to

offer hope that will be realized in spite of disaster circumstances.

The chaplain in disasters provides caring ministry through prayerful

intercession even when fear grips his or her own heart, attending to the victim’s

perceived need before his or her own. Prayers are often spontaneous and

informal, but personalized prayers are highly effective and comforting.

Ministry Tasks of the Chaplain in Disasters21

The task of the chaplain in disasters is to willingly enter the field of disaster

and discomfort to stand with those who have been hurt and suffer losses.

Assessing the needs of this “flock” of victims, the chaplain must lead them to

resources that will nourish their spirits and calm their trembling hearts. This

chaplain must walk alongside, listen to the story, promote a sense of safety and

security, and allow the overflow of God’s grace in his or her own life to spill into

the emptiness of those in need.

As a minister, the chaplain in disasters may lead religious services or

memorial services. These services may occur in makeshift facilities, in the

middle of rubble, or standing outside the morgue. Frequently, the ministries are

brief and simple—urgent, but meeting the immediate need. The chaplain will be

God’s voice, healing, reconciling, confronting, offering hope.

Through prayer for the hurt and needy, the chaplain in disasters assumes the

role of minister for people of every faith and religious tradition. Invoking God’s

presence, wisdom, power, and grace, the chaplain intercedes for victims, rescue

workers, and concerned people around the world. Individual prayers, formal

prayers, corporate prayers—all are utilized and appreciated by most.

The ministry of disaster relief chaplains is a response to the command:

“Bear one another’s burdens, and thereby fulfill the law of Christ” (Gal. 6:2,

NASB). “The word for ‘burden’ (baros) means literally ‘a heavy weight or

stone’ someone is required to carry for a long distance. Figuratively it came to

mean any oppressive ordeal or hardship that was difficult to bear.”22 Everyone

has burdens, but the burdens that result from emergencies and major disasters are

often more than one is able to bear alone. Carrying the heavy weight of death,

loss of home, or destruction of property is an oppressive ordeal that is difficult to

bear alone. “God does not intend for us to carry them by ourselves in isolation

from our brothers and sisters. . . . The myth of self-sufficiency is not a mark of

bravery but rather a sign of pride.”23

Personalized prayers a. short b. specific c. spontaneous

A chaplain is a “minister” to victims

Chaplains offer prayers for victims

Chaplains share the burden of loss


Sometimes, sharing the love of Christ is the most helpful way to carry

another’s burdens. When victims perceive they have no resources to bear their

own burdens, they receive great comfort in knowing that chaplains share their

burden out of the overflow of Christ’s love in them. Sharing the “Good News” in

appropriate and sensitive ways could demonstrate compassion to victims who

carry the weight of great disaster losses.

As the representative of God, the chaplain in disasters ministers to all who

are wounded and hurting in crises and emergencies. Unlike the local minister

who primarily ministers to his own flock, the disaster chaplain’s flock is any

who are victimized. As the disaster relief chaplain steps onto the field of

disaster, he or she offers the arms of God, hears the cries of distress, and

provides strength at the point of exhaustion to those who are weary. The

chaplain in disasters demonstrates compassion, for it is a heart of compassion

that bears another’s burdens (see Col. 3:12-13).

Chaplains in disasters minister to any who are victimized

Differences Between Chaplains in Disasters and Community Clergy26

There are often inadequate numbers of trained professional disaster relief

chaplains available to handle the crisis situations that arise in the event of major

disasters and emergencies; often other chaplains, pastors, and clergy of local

congregations respond with the intention of providing compassionate care to the

victims of these disasters. There are several issues that become evident:

Spiritual care in disasters is very different from that in the pastorate.

Ministering within religious diversity is different than in the context of

a church congregation.

The trauma response in disasters requires specialized training and care.

When clergy are not skilled in addressing these issues (and many others that

are equally important27), they fail to provide appropriate ministry to the victims

and often leave the scene feeling inadequate, overwhelmed, or in personal crisis

themselves. Likewise, the victims feel unheard, ignored, discounted, judged, or

even threatened. There is little effective ministry that occurs.

The events of September 11, 2001—the terrorist attacks on the World Trade

Center and the Pentagon—made it exceedingly clear that major disasters can

happen and that there are not enough trained disaster relief chaplains to meet the

needs of disaster victims. The call to disaster ministry has become evident to

more seminarians and people in ministry, but another significant problem is the

prohibitive nature of extensive professional training for those who desire to be

available in the event of disasters in addition to their normal responsibilities.

The question arises: can a person become effective in disaster chaplaincy

with 16 hours of crisis ministry intervention training? The response is yes, if the

training is specific and concise, and if the ministry intervention is intended to be

“spiritual first aid,” not “long-term care.” For example, emergency medical

technicians (EMTs) receive specific and concise training to provide medical first

There are several differences between ministering to a congregation and to the victims in a community

Special skills are required for disaster ministry

The need for disaster ministry is likely

Chaplains in disasters are like “spiritual paramedics”24


aid at the scene of the crisis incident. There is no expectation for providing long-

term care, which is more appropriately left to physicians who receive many more

years of education and training. Chaplains in disasters are trained to provide

urgent care by diffusing distress through their early intervention and cathartic

ventilation. They are “spiritual paramedics.”

Southern Baptist disaster relief chaplains must also complete the seminar,

Involving Southern Baptists in Disaster Relief, the basic training for all Southern

Baptist disaster relief volunteers. Additional seminars may also be available to

those who wish to further develop crisis intervention skills. These additional

seminars are not required for basic Southern Baptist Disaster Relief chaplaincy.

There is an urgent need to train volunteers to be disaster relief chaplains,

providing appropriate spiritual care to the direct victims (the victims who live in

the area of destruction), the indirect victims (the victims who live on the fringes

of the disaster area—often inconvenienced but not radically affected by the

disaster), and the hidden victims (the relief workers and professional

caregivers).28

Summary: Contrasting the Differences

Pastors and other Congregational Pastoral Caregivers

minister to one “set” group of people on a long-term basis

know the people fairly well or very well

minister in “ordinary” times

minister to a group of people who have like or similar religious beliefs

minister to a group of people who have chosen to be a part of this group

minister in the context of common cultural identities

are given authority by a congregation or ecclesiastical body

Disaster Relief Chaplains

minister to people they have never met or do not know very well

minister to victims who do not call them or choose them

minister to people who are in crisis when they meet

minister to a wide variety of cultural and ethnic groups of people

minister to many different religious traditions

minister to people who do not know “what” a disaster relief chaplain is

are given authority by an institution or agency to seek an invitation by victims

What are some significant differences that you will face?

1.

2.

3.

How will you prepare yourself to overcome these differences?

1.

2.

3.

Involving Southern Baptists

in Disaster Relief is the basic training for all Southern Baptist disaster relief volunteers

Training for disaster relief chaplaincy is urgently needed

Differences between pastors and disaster relief chaplains

The most significant difference I will face is . . .

I will overcome these differences by . . .


A special issue that surfaces for pastors and other congregational leaders

is chain-of-command. Disaster relief organizations often function as para-

military organizations. To function effectively, the chain-of-command is very

rigorously observed. During disaster relief operations, pastors and other

congregational leaders who are accustomed to being in command will serve

under the direction and leadership of others. Being able to redefine one’s

responsibilities and leadership role will be essential to the effective functioning

of the overall response team.

“Chain-of-command” means following orders from above


OVERVIEW OF THE CRISIS RESPONSE29

UNIT 2

Understanding the Terminology and Concepts

The following terms are offered to the disaster relief chaplain to provide insight from experts who approach crisis with a psychological perspective rooted primarily in science. These insights may be enhanced with the addition of the perspectives of faith and spirituality that are the special focus of disaster relief chaplains. . Chaplain: a clergyman in charge of a chapel; officially attached to a branch of the military,

to an institution, or to a family or court; a person chosen to conduct religious exercises (Webster, 10th ed.)

Compassion: a feeling of deep sympathy and sorrow for another who is stricken by suffering or misfortune, accompanied by a strong desire to alleviate the pain or remove its cause

Crisis response: an informed response to the emotional disruption that occurs after a critical event; also known as a crisis intervention

Crisis: an acute human response to an event wherein psychological homeostasis (balance) has been disrupted; one’s usual coping mechanisms have failed; and there are signs and/or symptoms of distress, dysfunction, or impairment (Caplan, 1961, 1964)

Critical incident: a stressor event (crisis event), which appears to cause, or be most associated with, a crisis response; an event which overwhelms a person’s usual coping mechanisms (Everly & Mitchell, 1999); the most severe forms may be considered traumatic events

Crisis intervention: the urgent and acute psychological support sometimes thought of as “emotional first-aid”

Cross-cultural: effectively operating outside the boundaries of a particular cultural group

Cultural awareness: developing sensitivity and understanding of another ethnic group; usually involves internal changes in terms of attitudes and values; refers to the qualities of openness and flexibility that people develop in relation to others (Adams, 1995)

Cultural competence: a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency, or those professionals to work effectively in cross-cultural situations (Cross, Bazron, Dennis, & Isaacs, 1989); emphasizes the idea of effectively operating in different cultural contexts

Cultural knowledge: familiarization with selected cultural characteristics, history, values, belief systems, and behaviors of the members of another ethnic group (Adams, 1995)

Adams, Diane L., ed. Health Issues for Women of Color: A Cultural DiversityPerspective. Thousand Oaks: SAGE Publications, 1995.

Bazron, Cross T., K. Dennis and M. Isaacs. Towards a Culturally Competent System of Care, vol. I. Washington D.C.: Georgetown University Child Development Center, CASSP Technical Assistance Center, 1989.

Caplan, G. Principles of Preventive Psychiatry. New York: Basic Books, 1964.

Mitchell, Jeffrey T. and George S. Everly, Jr. Critical Incident Stress Debriefing: An Operations Manual for CISD, Defusing and Other Group Crisis Intervention Service, 3rd

ed. Ellicott City, MD: Chevron Publishing Company, 1997.

Selye, Hans. Stress in Health and Disease. Boston: Butterworth, 1976.

Texas Department of Health, National Maternal and Child Health Resource Center on Cultural Competency. Journey Towards Cultural Competency: Lessons Learned. Vienna, VA: Maternal and Children’s Health Bureau Clearinghouse, 1997.


Cultural sensitivity: knowing that cultural differences as well as similarities exist, without assigning values, i.e., better or worse, right or wrong, to those cultural differences (National Maternal and Child Health Center on Cultural Competency, 1997)

Disaster: a calamitous event, occurring suddenly and causing great damage or hardship (Webster); an unexpected event that causes human suffering or creates human needs that the victims cannot alleviate without assistance (ARC)

Disaster relief chaplain: a chaplain that responds to victims of disasters; trained in crisis intervention skills

Distress: prolonged or excessive negative stress reactions; they can cause harm

Emergency: a sudden, urgent, usually unforeseen occurrence or occasion, requiring

immediate action

Eustress: a positive stress reaction that motivates one to make positive changes, grow, and achieve goals

Human diversity: the state of being diverse as mankind; unalike in many characteristics—

Iphysical, moral, spiritual, intellectual, historical, familial

Interdisciplinary team: a group of specialists that represent several different professions, disciplines, or agencies

Multidisciplinary team: a group of specialists that represent several different professions,

disciplines, or agencies

Pluralism: a coalition of diverse ethnic, racial, religious, or social groups seeking to maintain autonomous participation in and development of their traditional culture or special interest within the confines of a common society; religious pluralism seeks an environment in which all faith expressions can dwell together

Presence: state or fact of being present, as with others or in a place; God’s initiative in encountering people

Psychology: study of mental processes and behavior; emotions and behavioral

characteristics

Psychotraumatology: study of psychological trauma in contrast to ‘traumatology” which deals with the study of physical wounds in physical medicine (Schnitt, 1993)

Religious diversity: the state of representing several religious traditions

Sensitivity: the state or quality of being sensitive; readily or excessively affected by external agencies or influences; highly responsive

Story listening: listening to the narrative that tells the story of the event; interpreting and

understanding the significance of a person’s account of the crisis event


Stress: a response characterized by physical and psychological arousal arising as a direct result of an exposure to any demand or pressure on a living organism; the sum total of “wear and tear” that accelerates the aging process; the non-specific response of the body to any demand made upon it (Selye, 1956, 1974)

Suffering: to undergo or feel pain or distress; to sustain injury, disadvantage, or loss; to undergo, be subjected to, or endure pain, distress, injury, loss, or anything unpleasant

Trauma: an event outside the usual realm of human experience that would be markedly

distressing to anyone who experiences it; the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; APA, 1994) defines trauma exclusively in terms of the exposure to human suffering, i.e., personal or vicarious exposure to severe injury, illness, or death. A trauma, therefore, may be seen as a more narrow form of critical incident (a crisis event that causes a crisis response)

Traumatic event: an event outside the range of usual human experience that would be markedly distressing to almost everyone (DSM-III-R [APA, 1987]); an exceptionally threatening or catastrophic event (WHO, 1992)

What Constitutes a Disaster?

The American Red Cross defines a disaster as a “situation that causes

human suffering or creates human needs that the victims cannot alleviate without

assistance.” Disasters by this definition could vary greatly in extent of damage,

victimization, and origin. Typically, disasters

affect several people or entire communities

are unexpected or sudden

have an element of danger

cause injury or loss of human life

cause property damage or loss

Why is it that people experience the same disaster event and respond

differently? Why do some people have such severe distress while others seem to

have minimal negative reactions? Understanding, experience, age, history—

these and many other factors may affect the response. For the chaplain, it is

essential to remember that perception greatly affects the distress a victim may

experience. A perceived loss, no matter how real or unreal it may be, is still a

loss to the victim. Therefore, the disaster may be perceived either as a

calamitous event or a non-disaster.

If crisis is an acute response caused by a change in psychological homeostasis

(balance), a perceived change or a perceived loss will produce signs or

symptoms of distress, dysfunction, or impairment. For some victims, the

property loss may be secondary to the perceived loss of position, status,

relationships, independence, reputation, or integrity.

Disasters vary greatly in extent of damage, victimization, and origin

Perception of the event will influence the reaction

The perceived loss may be intrapsychic


Types of Disasters

Natural Disasters

Natural disasters are often called “acts of God.” Southern Baptist Disaster

Relief and other disaster relief organizations often include earthquakes, floods,

tornadoes, blizzards, hurricanes, tidal waves, wild fires, and volcanic eruptions in

this category. Disaster services organizations also include some conditions that

result from these events—mud slides, avalanches, and so on.

Man-made Disasters30

In recent years, man-made disasters have captured the attention of many

Americans. Many of these man-made disasters have a criminal component.

They are crimes against people and humanity. Rapes, battered people, abused

children, the elderly, school violence, shootings and other assaults, suicides and

suicide attempts, extraordinary financial or property losses through fraud or

theft, arson, riots, and chronic community violence are now overshadowed by

terrorism and bombings. Man-made disasters include accidents in airplanes,

trains, ships, buses, and transportation vehicles of every kind. Drowning also

accounts for many disasters. For many, disasters are health related in the form of

epidemics and widely spread diseases—some through biological warfare and

terrorism. Other man-made disasters include industrial accidents, fires,

structural collapses, and hazardous material spills.

The most devastating catastrophe caused by humans is war. The emotional,

physical, psychological, and spiritual losses sustained as a result of war are

overwhelming. In addition to loss of life and limb, there are issues surrounding

displacement as refugees, national identity, and property loss.

What Happens During a Community Disaster?

Most communities have experienced some form of disaster. Some have

experienced natural disasters and others have experienced the results of war,

crime, and accidents. In 2001, the United States experienced disaster as a nation.

When destruction affects an entire community, there are some common

characteristics.

The numbers of people involved are often great. There may be

many dead and injured.

What would be the “community crisis need?”

There may be extensive physical destruction of homes, property,

and possessions.


Natural disasters—“acts of God”

Man-made disasters—crimes, accidents, health-related, and so on


There may be massive numbers of displaced people and animals.


There may be interruption of transportation.


There may be interruption of public utilities.


Businesses, industry, employment, and so forth may suffer severe losses.


Individual people may have huge financial losses.


There may be political confusion.


The immediate needs:

Shelter

Food/water

Safety

The community in disaster may fragment or draw together. Either way, the

problems and issues will remain. The chaplain in disasters may not be able to

deal with all the issues of the community, but he or she will certainly be needed

in dealing with the disaster issues that individuals face. The task will appear

daunting—and it is. But caring interventions are necessary and effective, one

person at a time.

Recovery needs:

Repair homes/businesses

Remove debris

Provide food/water

Long-term needs:

Rebuilding

Financial support

Jobs


Who, What, When, Where, Why, and How of Crisis Response

Every disaster and critical incident is unique. There are no two that result in

exactly the same responses. The chaplain in disasters must quickly do some

general assessments and have some understanding regarding the crisis response.

Think of a specific disaster and try to answer these questions:

Who will respond?

Who is the victim of the disaster?

First responders

Direct victims

Indirect victims

Who is “in charge” during the disaster?

What happens immediately following the crisis event?

What is a chaplain allowed to do during a crisis event?

When does the chaplain respond to a crisis event?

When does the chaplain do “crisis intervention”?

Where does crisis intervention happen?

When does crisis intervention stop?

How does the chaplain know what intervention to use?

How is responding to an airplane accident different?

How does the response in a natural disaster differ from a man-made

incident?

How is a terrorist attack different?

How is a bank robbery different?

How is a school shooting different?

How is a death in the workplace different?

How does the “command staff” know a chaplain is qualified to do crisis

intervention?

Every disaster situation has an agency that has been identified and charged

with the responsibility. It is always important for chaplains to be a part of an

established and recognized crisis intervention team when they respond to

disasters. No chaplain should ever “show up” uninvited. This type of self-

deployment often causes confusion and additional chaos for the command staff

who are trying to organize the intervention efforts. When chaplains arrived on

the scene in New York City after September 11, many had no lodging or

provision for personal needs. While the intention “to help” was appreciated, the

additional effort that was required to find housing and parking, to verify

credentials, and to maintain organization was tremendous in the wake of already

exhausted personnel.

In some instances, disasters are a result of criminal activity. In these cases,

law enforcement has jurisdiction and there are many prohibitions surrounding

who may participate, where they may locate, who may be approached, and what

may be said. In the event of criminal activity, the crisis intervention team leader

will take primary responsibility for interfacing with security.

Chaplains in disasters must answer the 5 W +H questions

Chaplains in disasters must be part of a recognized crisis intervention team

Never “self deploy” to a disaster scene

Law enforcement has jurisdiction over crime scenes


Victim Classifications

Some crisis intervention organizations list as many as seven levels of victim

classifications as a result of disasters, from the primary victim to the person who

thinks that only by the luck-of-the-draw did he or she escape being a primary or

secondary victim. The Southern Baptist Disaster Relief publication, Involving

Southern Baptists in Disaster Relief, lists the following classification of victims

of disasters:

1. Direct victims—those in the immediate area of the destruction who have

suffered losses

2. Indirect victims—those who are not directly impacted by the disaster,

but are somewhat affected by the resulting annoyances and

inconveniences or have close relationships with direct victims

3. Hidden victims—those who respond to the disaster as first responders

and relief workers, including law enforcement, emergency medical

services, disaster relief chaplaincy, and disaster services

Emerging Issues for People and Groups Involved in Disasters

People and groups of people who are involved in disasters face many issues

during and after the critical incident. Recognition of some of these issues will be

helpful for the chaplain who interacts with people in crisis. Direct victims may

verbalize issues that appear to be in conflict with those of survivors, and first

responders may view successful rescue much differently than others.

Here are a few emerging issues for people involved in disasters:

Direct Victims Immediate danger and life threatening situations

Physical injury and/or pain Dislocation and separation anxiety

Death of family and/or friends and survivor’s guilt

Unknown future

Indirect Victims and Survivors Relief and guilt Preoccupation with the disaster circumstances

Imaginative reconstruction of victim’s suffering

Inconvenience

Family and Loved Ones “Next-of-kin” responsibilities

Relief and guilt Preoccupation with the disaster circumstances

Imaginative reconstruction of victim’s suffering

First Responders Rescue and failed rescue

Search and unfruitful search

“Hero ethos”

Victims in disasters:

1. Direct victims 2. Indirect victims 3. Hidden victims

Emerging issues for people involved in disasters


Legal responsibilities and jurisdiction

Triage

Disaster Relief Workers Unexpected responsibilities and tasks Inadequate resources—supplies, language, time, network

Extended exposure to disaster and consequent bonding with

community

Extended separation from family and personal support

“Unsung hero”

Chaplains “Messiah” complex

Role confusion

Inadequate resources—language, time, network


HUMAN NEEDS AND DEVELOPMENT31

UNIT 3

Maslow’s Hierarchy of Needs—Identifying the Crisis

Abraham Maslow was a psychologist. He believed that humans strive for

upper levels of capabilities—fully functioning personhood, healthy personalities,

or as Maslow calls this level, "self-actualization." Maslow set up an instinctoid

hierarchic theory of needs based on five levels of basic needs. Within the levels

of the five basic needs, a person does not feel the higher need until the demands

of the lower needs have been satisfied.

According to Maslow, there are general types of deficiency needs

(physiological, safety, love, and esteem) that must be satisfied before a person

can act unselfishly. These needs are prepotent, ones that have the greatest

influence over our actions. Each person’s prepotent needs vary. A teenager may

have a need to feel that he or she is accepted by his or her peers. An alcoholic

will need to have a drink to “start the day,” or a homeless person may need food

and water. When the prepotent needs are met, higher needs emerge and

dominate a person’s attention.

Maslow’s Hierarchy of Human Needs is often represented as a pyramid,

with the larger, lower levels representing the lower, more basic needs, and the

upper point representing the more spiritual need for self-actualization. Maslow

believed that the reason people did not move well in the direction of self-

actualization is because of hindrances (disasters?) placed in their way. The

movement is not linear but dynamic, constantly changing with environmental

factors which act as obstacles.

The five levels of needs identified by Maslow were physiological,

safety/security, belonging/social affiliation, self-esteem, and self-actualization.

Each level is characterized by specific needs within the human scope of

requirements for life. They are represented as a pyramid in Figure 1.

Physiological Needs

Physiological needs are the most basic needs such as air, water, food, a

relatively constant body temperature (clothing, shelter), sleep, and so forth.

When these needs are not satisfied, we feel motivated to alleviate them as soon

as possible to establish homeostasis. The physiological needs are the strongest

needs.

Safety and Security Needs

When all physiological needs are satisfied and no longer dominant, the

needs for safety and security can become active. Times of emergency or chaos in

the social structure (such as widespread rioting) make people aware of their

safety and security needs. Safety needs are mostly psychological in nature. We

Abraham Maslow’s theory

“Prepotent needs” have the greatest influence over our actions

Movement along the hierarchy of human needs is dynamic and changes with environmental factors

Maslow’s Hierarchy of Human Needs

Physiological needs

Safety and security needs


need the security of a home, family, law, and order—freedom from danger and

threats.

Safety needs sometime motivate people to be religious. Religion comforts

us with support and encouragement in the midst of death and the insecurity of

this world.

Self-actualization Our need to actualize or maximize our

potential as humans; uniquely expressed

for each individual in episodic fashion

Esteem

Our need for competency, adequacy, mastery,

attention, recognition, status, appreciation

Belongingness and love

Our need to relate positively to other people—

family, friends, associates, to give and receive

affection

Safety

Our need for safety, security, stability, and

freedom from fear and anxiety

Physiological

Our basic need for air, water, food, shelter,

sleep

Figure 1. Maslow's Hierarchy

of Human Needs. (From

Maslow, A. Motivation and

Personality (2nd ed.). New

York: Harper & Row, 1970.

Belonging and Social Affiliation Needs

When the needs for psychological and physiological well-being are

satisfied, the next level of needs for love, affection, and belongingness can

emerge. Maslow states that people seek to overcome feelings of isolation,

aloneness, and alienation. This involves both giving and receiving love, affection

and the sense of belonging. Humans have a desire to belong to groups: families,

clubs, work groups, religious groups, gangs, and so on. We need to feel loved

and accepted by others, giving and receiving friendship and associating with

people (a social context in which to validate a person's perceived worth).

Esteem Needs

When the first three classes of needs are satisfied, the needs for esteem can

be addressed. These involve needs for both self-esteem (from competence or

mastery of a task) and for the esteem a person gets from others (attention,

appreciation, and recognition from others). People who have satisfied their

esteem needs feel self-confident and valued. When these needs are not met, a

person feels helpless and worthless.

Self-Actualization Needs

When all of the physiological, psychological, emotional, and social needs

are met, a person has the desire to maximize his full potential. Maslow describes

self-actualization as a person's “desire to become more and more what one is, to

become everything that one is capable of becoming.” These people experience a

restlessness that urges them to self-development, self-fulfillment, knowledge,

and oneness with God and the universe.

Belonging and social affiliation needs

Esteem needs

Self-actualization needs


Identifying the Crisis

The first task of the chaplain in disasters is to assess the immediate need—

from both the victims’ perspective and from that of the caregiver. Understanding

and applying the principles from Maslow’s Hierarchy of Needs will assist the

chaplain in disasters to determine the crisis need of the victim. The primary

response in disasters and other emergencies is physical survival. When rescue

workers and caregivers arrive on the scene, medical injuries and issues are

addressed first. Congruent with Maslow’s theory, vicitms’ basic needs are first

met—air, water, food, clothing, and shelter. Because disasters are a significant

disruption to homeostasis, there is a sense of urgency to assist the victim in

reducing acute physical traumatic stressors. Victims need medical assistance and

physical resources.

How could you provide for physiological needs—basic human needs?

1.

2.

3.

When physical survival and basic needs are met, caregivers are able to

address other presenting needs. Victims have a need to be assured of their safety

and security. They want to know that their family and friends are safe. They

want to know that their home and belongings are safe. They want assurance of

safety from impending danger and the security of qualified assistance. They

need the security of confidentiality and privacy. They need to perceive that they

are safe from imminent danger.

How could you assure a victim of his or her safety and security?

1.

2.

3.

Three phases are prevalent in disaster relief responses and are often present

in other kinds of crisis interventions: 1) rescue, 2) recovery, and 3) rebuild.

During the rescue phase, people are seldom ready to move beyond Maslow’s

levels of basic needs and social affiliation needs (social affiliation is related to

belonging and in this case implies that someone else has gained a strong

understanding of what the victim is feeling and has experienced). Once their

basic human needs are met, victims who feel relatively safe and secure become

concerned about having a positive relationship with others. Communicating and

uniting with family, friends, and/or others who have experienced the same

disaster becomes important in feeling like one is part of a community with a

shared identity. Such efforts also contribute to feeling connected and secure.

Isolation and abandonment lead back to insecurity and a sense of danger.

During the initial phase of response, spiritual care should complement

efforts to meet people’s basic and social affiliation needs while helping them

draw upon basic spiritual activities like prayer. As victims are receptive to

stabilization via spiritual resources, chaplains should help individuals engage

personal and other available assets in order to facilitate movement toward the

recovery and rebuild phases. As chaplains heighten the awareness of spiritual

What is the victim’s crisis need?

Physical survival is first

Victims need to perceive they are safe


possibilities and progress with their presence by offering helpful suggestions,

they facilitate crisis mitigation and contribute to creating an environment that

may allow victims to experience the higher levels of Maslow’s paradigm.

Support for spiritual reflection and transformation should be afforded and

readily available to persons at any stage of a disaster so they can encounter such

horizons, if and when they are ready to do so. The faithful presence and devoted

service of a chaplain in the early phases of a crisis often contributes to credibility

for chaplains and other spiritual care agents, which allows them to introduce new

coping skills, positive reaction patterns, and wholesome ways to think about the

experience. Those impacted by the crisis can then employ these new insights as

they move toward the later phases of a crisis experience and/or consider how to

handle future crises. As chaplains remain patient and respectful of a victim’s

personal boundaries in the process of identifying and helping meet their needs,

the opportunity for positive change often introduced by a crisis situation

becomes available. This kind of ministry involves a fine balance between a keen

awareness of people’s needs and a discerning sensitivity to the work of God in

their lives.

How could you help a victim meet belonging and social affiliation needs?

1.

2.

3.

Remember, chaplains in disasters are administering psychological and

spiritual first aid, not therapy. The basic goals are to mitigate acute distress,

reduce symptoms, increase adaptive capabilities, and facilitate continued care—

all under the umbrella of spiritual care through the ministry of presence, the

ministry of compassion, and the ministry of care. Chaplains in disasters are a

“value-added” component of crisis intervention and disaster response. They are

able to provide essential crisis interventions and spiritual crisis interventions.

Spiritual needs are evident at all levels of Maslow’s pyramid. If

spirituality is the understanding, integration, and response to the transcendence

of God (see Unit 9), then, victims are dealing with spiritual issues even as they

deal with hunger, thirst, safety, or aloneness. Chaplains in disasters have

opportunities to remind victims of God’s providence and presence even as they

struggle with meeting basic physiological, safety, or belonging needs.

Application for chaplains in disasters

Stages of Human Development—The Age-Specific Human Response

to Crisis

Erik Erickson developed a theory for human psychosocial development

that is consistent among humans, regardless of ethnicity, gender, language,

socio-economic status, or education and experience. Erikson identified eight

basic stages of life through which the human personality is developed. Within

each stage, there are characteristic perspectives that are consistent among all

humans within similar age ranges, resonating with classic psychoanalysis.

Erik Erikson’s Eight Stages of Human Development33


As an individual grows and matures, each successive stage contributes to

the overall health and wholeness of the individual. Human development is

dynamic—ever changing and growing. Consequently, understanding the needs,

feelings, and attitudes of each successive stage will be helpful in providing

compassionate, effective ministry to all victims in distress.

Trust versus Mistrust (Birth—2 years old)

The first developmental component of a healthy personality is cultivated in

infancy. The infant learns trustfulness of others and trustworthiness of self.

Being totally dependent upon others for basic survival needs, the infant learns to

trust others to provide those needs. Erikson states that the amount of trust that

is developed has everything to do with the quality of the maternal relationship

and little to do with the quantity of needs being met (i.e., food, attention).

Autonomy versus Doubt (2—3 years old)

During this stage of development, the child begins to demonstrate his or

her own will. He or she learns to hold on and to let go—“Mine!” or throw it on

the floor. With muscular maturation, the child also experiments with retention

and elimination. There is a struggle to be independent, but still feel “safe.” The

child is aware of his or her separateness but sudden or prolonged separation

may generate anxiety through feelings of abandonment. There is doubt about

the ability to be autonomous.

Initiative versus Guilt (3—6 years old)

With autonomy comes mobility, language, and imagination. The child has

a desire to be, to do, to create, to achieve. He or she becomes aware of limits

and expectations, feeling guilt when he or she fails to reach the limits or is

unsuccessful in meeting the expectations of parents or caretakers. Children at

this stage are most able to learn quickly and engage in cooperative activity—

play and make things with. They are self-aware and purposeful.

Industry versus Inferiority (6—12 years old)

During the elementary school ages, children apply their initiative and

imagination in a more disciplined way—they learn through systematic

education and example. They develop a sense of wanting to complete work,

gaining favor by producing things. They cooperate in effort and share labor.

When they do not accomplish things at the level they perceive they should, they

develop feelings of inferiority and inadequacy.

Identity versus Identity Confusion (12—18 years old)

These are the years when a child wants “to be my own self” by conforming

to the expectations of his or her peers—his or her significant relationships.

Recognizing the images of adulthood, the teenager faces the challenge of

discovering and becoming who he or she is and who he or she will be. With

hope and will and purpose and competence, the teenager must be true to his or

her own nature—“be his or her own self.” He or she identifies with peers,

Infants develop hope

Toddlers test their will

Preschoolers have a purpose

Elementary school age children become competent

Teenagers expect fidelity


gangs, teams, and groups. When he or she is confused about his or her role, he

or she faces his or her own crisis and runs away, withdraws, rebels, or defaults

into a role that is thrust upon him or her (i.e., you’re a delinquent, you’re a

failure, you’re bad).

Intimacy versus Isolation (19—35 years old)

When the teenager is more confident about his or her identity, he or she is

able to enter into intimate personal relationships with others. Discussing

feelings, hopes, aspirations, dreams, plans, and other self-revealing topics, the

young adult begins developing intimacy with people in general and with a mate.

When intimacy is rejected, the youth seeks isolation and distance. This is a

stage of commitment and love.

Generativity versus Stagnation (35—65 years old)

The person who enters midlife is concerned about establishing and guiding

the next generation—sometimes as a parent and sometimes as a caregiver or

philanthropist. These are the years of careers that “make a difference,”

organizations that impact society, and causes that ordain the future. When

people fail at accomplishing these goals, they perceive themselves as

impoverished—“life has no meaning.” The perception is that life is stagnant

and nonproductive.

Integrity versus Despair (65+ years old)

Adults who have reached this stage of development have experienced

success and failure—and live with acceptance of it. They accept their life

experience as their own responsibility and are comfortable in it, to the point of

defending their personal lifestyle. They live with wisdom born of experience

and maturity born of acceptance. External affirmation is less needed and there

is greater awareness of participation in the community of humankind while

maintaining his or her own integrity. The lack of this sense of integrity causes

despair—the feeling that there is no time left to start over and gain integrity.

Conclusions and Applications

The human developmental stages can be generally divided into three

chronological groups—children, adults, and the elderly. Within each of these

age groups, there are developmental issues that are generally common to all in

that age group. It becomes incumbent upon the disaster relief chaplain to be

aware of these issues and their resulting needs in order to provide the

appropriate care. An infant will need the comfort of being held more than the

assurance of communion with his peers.

Assessment of needs will be enhanced as the disaster chaplain identifies

issues surrounding physical necessities, cognitive inabilities, emotional

dysfunction, social isolation, and spiritual despair that are typical of people in

particular developmental stages.

Young adults love someone

Mid-lifers care about guiding and establishing the next generation

Elderly have wisdom and self- acceptance

Conclusions and applications for chaplains in disasters


Erikson defined the stages of development, their corresponding virtues,

and radius of significant relationships. Figure 2 illustrates the crisis need and the corresponding reactions in each developmental stage. It also provides some

resources for informed crisis response by the disaster relief chaplain.32

Crisis Responses for the Eight Stages of Life

STAGES VIRTUE RADIUS OF

SIGNIFICANT RELATIONS

PSYCHOSOCIAL MODALITIES

VICTIM CRISIS REACTION

CRISIS NEED CRISIS INTERVENTION

Trust/Mistrust Birth - 2

Hope Maternal Persons To get To give in return

Abandonment, disorientation, fear

Trust, physical contact Physical contact (carrying, holding), restore primary caregiver

Autonomy/Doubt 2 - 3

Will Paternal Person To hold (on) To let (go)

Fear, doubt, separation anxiety, abandonment

Trust, care, direction, attachments

Physical contact (sitting beside, holding hands), restore caregivers

Initiative/Guilt 3 - 6

Purpose Basic Family To make (=going after) To “make like” (=playing)

Fear, doubt, guilt, abandonment

Trust, care, direction, attachments, stability, order

Physical contact (sitting beside), restore family, reassurance

Industry/Inferiority 6 - 12

Competence “Neighborhood,” School

To make things (=completing) To make things together

Fear, doubt, inadequacy

Trust, care, direction, friends, stability, order, assurance

Restore attachments, establish routines and order, reassurance

Identity/Identity Confusion 12 - 18

Fidelity Peer Groups To be oneself (or not to be) To share being oneself

Estrangement, denial, anger, fear

Trust, order, identity, peer relationships, confidence

Provide identity, restore peer attachments, privacy

Intimacy/Isolation 19 - 35

Love Mate, Colleagues, Partners in Friendship

To lose and find oneself in another

Denial, anger, fear, isolation

Trust, order, control, normalcy, empowerment, confidentiality

Empower with choices, restore order, assure confidentiality, provide information

Generativity/Stagnation 35 - 65

Care Shared Household, Divided Labor

To make be To take care of

Denial, anger, fear, isolation

Trust, order, control, normalcy, empowerment, privacy

Empower with choices, restore order, assure confidentiality, provide information

Integrity/Despair 65+

Wisdom Humankind, “My Kind,” Children

To be, through having been To face not being

Slight denial, fear, some anger, disorientation, isolation

Trust, order, control, confidence, routine

Listen to stories and concerns, restore order and attachments, empower with choices, establish normal routines, provide dignity

Fig. 2. Naomi Paget, “Crisis Responses for the Eight Stages of Life,” adapted from Identity and the Life Cycle, Erik Erikson (New York: W.W. Norton &

Company,1980).



OVERVIEW OF THE TRAUMA RESPONSE

UNIT 4

Distress as the Trauma Response

The Nature of Stress34

Hans Selye, the “father” of stress research, defined stress as “the non-

specific response of the body to any demand made upon it.”35 Stress is a

response to circumstances, not necessarily a negative experience. In danger,

stress causes certain physiological changes in one’s body that prepares it for

fight or flight. Eustress is “good stress.” Eustress enables one to perform at

peak ability or exceed normal capacities. Distress is the destructive side of

stress, a stress reaction that is prolonged or excessive. Distress can cause harm.

Distress is nothing new—poverty, disease, and war have always led to fear,

uncertainty, vigilance, and frustration. But today, even those of us who are

neither poor, sick, nor in imminent danger of war are suffering stress from an

unprecedented number of sources. Stress is a response to change, and we are

experiencing change at faster and faster rates. Debt, hurry, and complexity

cause stress. Rapidly changing job markets make us feel insecure even when

we’re employed. Mobility and divorce separate us from supportive

relationships that would absorb distress. Study after study confirms that a

healthy marriage, family, or community support structure yields better health

and increased longevity. Yet the very stressors for which we need support

often put intolerable pressure on those relationships.36

Eustress causes one to make positive changes in one’s lifestyle while

distress is destructive to one’s health, emotions, and relationships. Jeffrey Mitchell says, “You will probably die from a stress-related disease if you are not

involved in an accident. . . . Life without stress is impossible.”37

One or two stressors usually do not cause a major stress response; however,

a “pileup effect” occurs when there is a lack of margin in one’s life and multiple

stressors are introduced. When a major distressing event occurs and there is no

margin available, the event is called a critical incident—an event that

overwhelms a person’s usual coping mechanisms. Disaster relief is ministry to

people experiencing critical incident stress (from major disasters).

The Internal Trauma Response

Most people live in a reasonably balanced state of equilibrium—physically,

emotionally, mentally, and socially. When they are exposed to a critical event,

these people must quickly adapt to new levels of equilibrium or their distress will

remain greater than their eustress.

The physical response to trauma38 is a complicated physiological interaction

between the body and the mind. Basically, when the brain receives the trauma

information through one of the five senses, it quickly processes the information

and interprets its significance based on historical evidence (memories of previous

Stress: “the non-specific response of the body to any demand made upon it.” (Selye)

Distress is the destructive side of stress

Stress piles up and becomes distress

The physical response to trauma is a complicated physiological interaction between the body and the mind


events), logic, and predictions. If the information is processed as a threat,

challenge, or significant change, a physiological stress reaction begins. This

reaction prepares the entire body to deal with the threat (trauma, stress).39

When faced with a sudden, uncontrollable, extremely negative event, a

person is fearful and seeks to protect himself from danger. This “fight or

flight” response observed in humans and animals facing danger (Lorenz,

1966) is characterized by high levels of physiological and behavioral

arousal. In humans, high levels of cognitive and affective arousal have also

been observed. High arousal when facing danger seems to be an unlearned,

preparatory response of the body and the mind to danger. In other words,

when you experience loss of control over your safety, your body and mind

automatically go on “red alert” in an attempt to regain control. The “red

alert” status might involve being hyperalert or hypervigilant to your

surroundings and having an increase in physiological arousal to allow for

flight or defense.40

Typically, adrenaline pumps through the body in a lifesaving response,

preparing the body to fight the danger actively or run away from the threat.

Breathing, heart rate, and blood pressure increase to provide more oxygen to the

body; pupils dilate to take in more light and increase visual acuity; sensory

perceptions increase; the body may relieve itself of excess materials through

regurgitation, defecation, or urination to facilitate fight or flight; muscles tighten;

and the liver produces ten times more blood glucose (the fuel for muscles). All

of these responses are healthy, normal responses to preserve life.

Selye called the fight or flight response the general adaptation syndrome.

The body does not distinguish between “good” stressors or “bad” stressors. An

extremely happy event could cause the same response as a life-threatening event

(e.g., seeing the birth of a child may cause a happy father to faint). However,

recent research does indicate that different chemicals and enzymes are released

into the bloodstream as a result of anger versus joy.

The mental response to trauma parallels the physical response. The initial

cognitive response is shock, disbelief, and denial. When cognitive function

temporarily stops, the victim may experience regression to a childlike state or

infancy (emotions become dominant). After the physical danger has ebbed, a

logical order of emotional reactions is manifested—fear and terror; anger, fury,

and outrage; confusion and frustration; guilt or self-blame; shame or humiliation;

grief or sorrow.41

In a crisis event, trauma causes the cognitive functioning of the brain to

become secondary, and there is a heightened state of emotional arousal. Victims

are overwhelmed with the event and cannot make normal, logical, or rational

decisions. They may seem “lost” or “in shock.” Common distress signals or

“symptoms of stress” may include the following: profuse sweating, nausea,

shakes, difficulties making decisions, generalized mental confusion,

disorientation (to person, place, time), seriously slowed thinking, denial, feeling

hopeless, wishing to hide, withdrawal, excessive humor or silence, change in

communications. Some symptoms require immediate medical attention (e.g.,

chest pain, excessive blood pressure, signs of severe shock, difficulty breathing).

The initial cognitive response is shock, disbelief, and denial

Trauma causes the cognitive functioning of the brain to become secondary, and there is a heightened state of emotional arousal


However, most symptoms are typical and normal reactions to an extraordinary

event.

Most people live in world in which they balance their physical, emotional,

cognitive, social, and spiritual lives. The balance is dynamic in nature.

Influenced by circumstances and daily events, each aspect of their nature is

called into priority. During a critical incident—a disaster or other traumatic

event—a person’s usual coping mechanism fails and signs or symptoms of

distress, dysfunction, or impairment become evident.

Critical incidents are constantly occurring. However, unless they are

perceived as threatening, the human response is not a trauma response—not a

response that is markedly distressing. During disasters, however, most people

interpret the event as a critical incident.

Biological Factors—Physical Response

After a shock to the system, the body’s response is biologically visible.

Generally, there is physical shock, disorientation, and numbness. In the 1930’s

Walter Cannon described this response as the “fight or flight” response. When

faced with overwhelming danger, the body instinctively prepares to fight against

the danger or to flee from the threat. In order to fight or flight, adrenaline begins

to course through the body, giving it energy and ability beyond its normal

capabilities. The body relieves itself of excess fluids and material to facilitate

increased action. The heart rate increases the flow of oxygen to the muscles and

the body begins to cool itself down for work by sweating or hyperventilating.

Self preservation dictates that sensory perception must increase and the senses

become acute. This physiological response is an emergency lifesaving response.

Symptomatic of this shock to the body and the need to fight or flight is the

decrease of mental efficiency. Cognitive functioning decreases as the body

prepares to “react emotionally” rather than “respond intellectually.” The victim

is less able to concentrate, experiences short-term memory deficiencies, becomes

mentally inflexible, and confused.

The alarm causes hyperarousal. People are known to physically accomplish

feats which would not normally be possible—lift a car off a child, run miles

without stopping. But hyperarousal cannot be sustained indefinitely.

Hyperarousal causes deep exhaustion and exhaustion creates more distress which

often manifests itself in other ways. Prolonged hyperarousal leads to

hypersensitivity of the stress arousal centers of the brain and future stress

responses become too easily activated (Every and Benson, 1989). Rest and

recovery are essential to return to a precritical incident level of functioning.

Psychological Factors—Mental Response

The psychological response to critical incidents is very similar to that of the

body—shock, disorientation, numbness. There is disbelief and denial over the

event because the mind is overwhelmed with the implications of the traumatic

Critical incidents cause symptoms of distress, dysfunction, or impairment

Physically, the body wants to “fight or flight”

Reactions versus responses

Rest and recovery are essential

Mentally, the mind wants to deny the event


event—it is more than the mind can comprehend. Consequently, cognitive

functioning becomes secondary to emotional functioning. During the “normal”

circumstances of life, the mind and body work in a fairly balanced manner with

little movement back and forth. When stimulated, the mind or body will become

dominant somewhat like the teeter-totter effect in Fig. 3.

_Cognitive Functioning Emotional Reactions _

During “normal” circumstances

Cognitive functioning is low and emotional functioning is high in disaster circumstances

Cognitive Functioning Emotional Reactions

During “disaster” circumstances

Fig. 3

How are you “balanced” right now? Draw it below:

Congruent with the fight or flight theory, during disasters, emotions are at a

peak, confused, and disorganized. The victim may be terrified, angry, confused,

or frustrated. The threat has caused the brain and cognitive abilities to diminish

so the emotions, which have taken precedence, can cause the body to positively

react out of fear, anger, or vulnerability (e.g., run away from danger). This is a

lifesaving emergency action. According to Maslow’s theory, survival is

paramount. Therefore, the victim’s mind will not be logically considering the

event, but his or her emotions will be racing for self-survival. Other emotions

may also come into play—guilt, shame, grief, helplessness, abandonment, and

worry. Disaster scenes are chaos and so is the mind.

The chaplain in disasters must be very sensitive to the victim’s perceived

threat of danger. The victim’s perceptions affect the reactions to the actual

traumatic event regardless of the chaplain’s perception or the “reality” of

the event.

Victims may “perceive” danger differently than the chaplain


Social Factors—Relational Response

People are social and their social environment affects their reactions during

and after disasters. The chaplain in disasters must consider many social factors

as they provide spiritual interventions.

Developmental stage (Erikson’s stages)

Family history or prior experience

Personality type

Cultural group

Ethnic

Gender

Age

Religion

Language

Position/authority

Profession

Socio-economic

Education

Everyone relates to a specific developmental stage. Everyone has some

family history or prior experience that informs the crisis event. Everyone has a

particular personality or disposition that will affect the crisis reaction. And,

everyone has some cultural orientation that adds perspective to the traumatic

event. But not everyone experiences the same cultural relevance. Some cultural

aspects may be more dominant than others (e.g., a person’s ethnic heritage may

affect his or her reaction more than his or her age).

Behavioral Factors—Action Response

Following a critical incident, behavioral activity may also experience a dramatic

change. There may be increases in activity or a noticeable decrease in activity. The

victim may withdraw, retreat into silence, become suspicious, or increase use of

profanity, alcohol, and tobacco. There may be visible changes in eating habits,

communication, or sleep habits. Sometimes the behavior is excessive—humor,

silence, crying, anger. The behavioral changes are directly related to the distress

experienced in the critical event.

Chaplains in disasters provide interventions that help mitigate the excessive

distress symptoms. It will be important to determine what the “typical” behavior was

pre–disaster.

Spiritual Factors—Faith Response

Disasters and other critical incidents cause a crisis of faith for many victims. Spiritual matters include all matters of belief and values—between people and

between people and God. Spirituality includes the search for meaning and

purpose, understanding the meaning of life and the cosmos, and exploring the

The effects of social and relational factors impact reactions in various ways

Crisis often causes extreme or excessive behavior

Disasters are a violation of value systems


transcendent. Therefore, disasters challenge people’s beliefs in God’s

sovereignty, moral and ethical absolutes, national principles and values, and

concepts of good and evil.

Whether one is actively engaged in religion or whether one has little or

nothing to do with religious matters, when disaster strikes, victims have

questions about their faith and God. Victims often seek spiritual support,

reassurance, guidance, and meaning.

Victims may react to the critical incident by seeking God’s presence

through the disaster chaplain. They may ask for prayer, intercession, or

purification. Some may blame God or view the disaster as divine punishment.

Others may blame the devil or other demons.

Initial questions such as “Why did God do this?” are usually not spiritual

questions as much as they are shock reactions of disbelief. Spiritual questions

usually surface after victims have been assured of physiological needs and safety

and security needs—when some cognitive functioning returns.

Crisis Intervention as a Response to Trauma42

The state of dysfunction that is caused by trauma and its resulting stress

symptoms is the primary issue with which crisis responders must deal. Some

responders primarily deal with medical issues (e.g., doctors, paramedics), and

some primarily deal with cognitive issues (e.g., mental health workers). But all

responders must be aware of all possible distress signals—physical, cognitive,

emotional, and behavioral.

Crisis interventionists are primarily concerned with the issue of stress,

specifically distress. The Critical Incident Stress Management (CISM) model for

trauma recovery outlines a sequence of steps for stress reduction intervention.

Because mitigating distress is critical in crisis intervention, CISM has adopted a

standard protocol that is a specific, systematic procedure for crisis intervention.

Crisis intervention is most effective when provided immediately following

the crisis. If stress and distress are not reduced, or if the event is extremely

catastrophic and extended over a long period of time (e.g., war, famine, nuclear

fallout), long-term stress reactions may occur. These may include post-traumatic

reactions (e.g., post-traumatic character changes, post-traumatic stress disorder,

acute stress disorder, adjustment disorder, or diagnosis of extreme stress not

otherwise specified [DESNOS]). Other long-term stress reactions may include

depression, simple or specific phobias, panic attacks, anxiety syndromes, or

dissociative disorders.43 CISM recognizes the urgency of mitigating stress and

distress after critical events.

A more detailed study of the spiritual dimensions of trauma is discussed in

Unit 9. This study is particularly essential in preparing pastors and chaplains to

respond to the spiritual factors that result from distress. Fig. 4 lists many stress symptoms that are associated with critical incidents. They are listed according to

the general categories in which they are demonstrated.44

Crisis responders must be aware of distress signals

Mitigating distress is essential in crisis intervention

Crisis intervention is most effective immediately following the crisis


STRESS SYMPTOMS

PHYSICAL COGNITIVE EMOTIONAL BEHAVIORAL SPIRITUAL

Chest pain*

Chills

Diarrhea

Difficulty breathing*

Disorientation

Dizziness

Elevated blood pressure*

Equilibrium problems

Fainting*

Fatigue Grinding of teeth

Headaches

Insomnia

Lower back pains

Muscle tremors

Nausea

Neck and shoulder pains

Nightmares

Profuse sweating

Rapid heart rate*

Shock symptoms*

Stomach problems

Thirst

Twitches

Uncoordinated feeling

Visual difficulties

Vomiting

Weakness

Blaming someone

Confusion

Difficulty identifying

familiar objects or

people

Disturbed thinking

Flashbacks

Heightened or lowered

alertness

Hypervigilance

Impaired thinking

Increased or decreased

awareness of

surroundings

Intrusive images

Loss of time, place, or

person orientation

Memory problems

Nightmares

Overly critical of others

Overly sensitive

Poor abstract thinking

Poor attention

Poor concentration

Poor decisions

Poor problem solving

Abandonment

Agitation

Anger

Anxiety

Apprehension

Denial

Depression

Emotional shock

Excessive worry

Fear

Feeling helpless about

life

Feeling hopeless

Feeling overwhelmed

Flat affect—numbness

Grief

Guilt Inappropriate emotional

response or lack of it

Intense anger

Irritability

Loss of emotional

control

Phobias

Rage

Resentment

Sever panic* (rare)

Uncertainty

Alcohol consumption

Antisocial acts*

Avoiding thoughts,

feelings or situations

related to the event

Changes in activity

Changes in sexual

functioning

Changes in speech

patterns

Changes in usual

communications

Emotional outbursts

Erratic movements

Hyper-alert to

environment

Inability to relax

Inability to rest

Loss or increase in

appetite

Nonspecific bodily

complaints

Pacing

Silence

Startle reflex intensified

Suspiciousness

Withdrawal

Acceptance or rejection

of providence

Alienation Anger directed to God

Awareness of the holy

Changes in religious

observances

Confusion regarding God

Deepened spiritual

awareness Emphasis on religious rites

Hyper-repentance

Imposed gratefulness

Increased emphasis on

religion

Isolation

Renewed search for

meaning

Sense of abandonment

Sense of betrayal

Sense of communion

Sense of

meaninglessness

Sense of vocation in

creation and

providence

Fig.4. Naomi Paget, Stress in the Workplace, Marketplace Samaritans, Inc., 2000. *Requires immediate medical intervention


THE ART OF STORY-LISTENING45

UNIT 5

Differences Between Hearing and Listening

The differences between hearing and listening may be mere semantics, but

for the purposes of this study, let us agree that hearing is the physical act of

sound entering the ear and resonating on the ear drum. Let us further agree that

listening is the assimilation of those physical sounds and their accompanying

body language with one’s own experience and integrating it into the present

experience to give those sounds meaning and voice.

Conversation, then, is the act of two or more people engaged in mutual

listening. During this process of conversation, each person is attempting to

communicate information. This interaction of communication is a distinction of

humankind and is essential in the effective interactions of chaplains in disasters.

Ethics of Listening

The chaplain in disasters is in a unique position to provide caring spiritual

intervention to people who are extremely vulnerable due to the trauma they have

experienced. Consequently, great care must be taken to provide a sense of safety

and security. Finding privacy in the midst of chaos may seem impossible, but

providing a sense of privacy may be possible through some basic interventions.

Asking permission to approach, to converse, or to provide help demonstrates

respect for victims’ personal space and privacy. Conversations are by invitation,

not entitlement. One or two caregivers will be less threatening than a group who

approaches a victim. Chaplains could advocate for victims by protecting them

from intrusive questions and media mania which are discomforting and

sometimes threatening.

Some professionals are legally required to maintain strict confidentiality.

Others are not. All chaplains in disasters are ethically bound to maintain

confidentiality. Vulnerable people say and do things that are distress reactions to

unusual circumstances. Chaplains should assure victims that their conversations

are private (if in fact they are) and confidential. If legal or policy issues limit

confidentiality, the chaplain must inform the victim. In disasters, victims view

caregivers as trustful and it is incumbent upon chaplains to honor that trust.

Many disaster relief chaplains have experience in pastoral counseling or

therapy. They have experience in asking the clarifying questions that provide the

background for the issues with which they are dealing. However, intervention in

disasters is emergency spiritual first aid, and some questions are better left

unasked. Chaplains must approach listening with an attitude of what do I need to

know. Asking for unnecessary details is intrusive and victims may have a sense

of distrust in the chaplain.

Hearing is a physical act

Listening is assimilating and integrating sounds and body language

Conversation is mutual listening

Provide a sense of privacy

Confidentiality is essential

Ask questions on a “need to know” basis


There are some situations in which the chaplain must divulge information

gained from a victim. Usually, these are related to whether non-disclosure would

cause harm to the victim or someone else. Some caregivers are required to

disclose information that threatens national security. Others are required to

reveal information that involves illegal activity. Before responding to a disaster,

each disaster chaplain must know which policies and statutes govern the

reporting process. It would be unethical to tell a victim after the fact that you

will be reporting some sensitive information to someone else.

Ministry of Presence

A major premise of disaster relief chaplaincy is presence. “The ministry of

presence” is immediate, humble, and intentional. Chaplains in disasters must

immediately step out of their comfort zone and intentionally enter a place of

crisis—danger, pain, loss, or grief—during and after the physical, emotional, and

spiritual crises of life.

Chaplains in disasters provide a listening presence as a spiritual act. Presence is both physical and emotional. With very few exceptions, the chaplain

must be physically with the victim. Through empathetic listening, the chaplain

must be emotionally present with the victim. The listener must do more than feel

with the victim. The ministry of presence demands that the listener will feel into

the fear, the pain, the anguish, or the isolation of the victim. Empathetic

listening assures the victim that words and feelings are being heard.

Many times, chaplains are so anxious to provide encouragement or to say

“the right thing,” that they are busy thinking about a response and not really

present to the words and feelings being expressed by the victim. Good listening

means the chaplain will be present to the victim by integrating the words, the

feelings, and the facts to give meaning and understanding to the experience.

Who is the speaker and who is the listener?

Presence may simply mean being there. Presence is grace—the gift of

being there. Presence is being available, even when other commitments and

obligations are significant. It is being physically present when the circumstances

are uncomfortable and even dangerous. Presence is being aware of emotional

upheaval and spiritual doubt and being open to its possibility for healing and

growth. Presence is being accepting of the disaster victim in whatever state one

finds him or her.

Ministry of Silence

Good listening means sometimes being silent. It is the silence that gives

strength and meaning to words. “Silence is an indispensable discipline in the

spiritual life. . . . Silence is a very concrete, practical, and useful discipline in all

our ministerial tasks.”46 Some ground is so holy that words are inadequate and

only silence is worthy of the time and place. Our words must spring forth from

the fullness and presence of the Divine—the presence of God within our own

Know the policies and statutes that govern your confidentiality

The power of the “ministry of presence” is in its immediacy, altruistic service, and intentionality

Chaplains must “feel into” the words and feelings of the victim

Present in body and spirit

Presence is grace, availability, physical presence, awareness, openness, and acceptance

Sometimes, silence is golden


souls and spirits. It is often in this silence that the deepest, most divine love

penetrates the individual’s crisis.

Some words are better unspoken—they do not edify. If in doubt, do not say

it. Most victims are in shock—they are confused and disoriented. Their

cognitive functioning is diminished and they are very emotional. This is not the

time to have complicated discussions or preach. A calm presence speaks

volumes in silence.

Before speaking, the disaster chaplain could ask:

Does it mitigate distress?

Will it stabilize or reduce the symptoms of distress?

Does it provide safety and security?

Does it offer real hope?

Will it be perceived as comforting?

Will it help restore normalcy?

Will it be a step toward God?

Improving Listening Skills

Most chaplains are skilled in the art of listening. During crisis situations

and disasters, one must become skilled in the art of story-listening. Telling the

story of what has happened is an important part of diffusing the distress of the

situation and chaplains must help victims tell their stories. Most often, telling the

story will take the form of conversation (some victims find expression in prayer,

music, or other art forms).

Clarify

As victims begin “telling their stories,” they begin to use words to describe

their experience, express their feelings, and articulate their responses. The

distress of the situation often makes it difficult for them to find accurate words to

communicate their feelings. It is often helpful for the chaplain to help clarify

these expressions by offering some synonyms for the words being used. When

chaplains are not aware of their own history and frames of reference, they make

assumptions about the meaning of words being used. It is best to clarify the

intended meaning by using synonyms and asking open-ended questions within

the immediate context of the conversation. Intrusive questioning is never

appropriate.

Paraphrase

A paraphrase is a restatement of the conversational text, using different

words but maintaining the integrity of meaning. The chaplain provides new

words with or beside (para) the original words that expressed the thought

(phrase). These new words are verbalized to the victim. The victim needs to

know that the chaplain in disasters has heard and understood the meaning of his

or her story.

If in doubt, do not say it

Chaplains must develop the art of story-listening

Use synonyms and questions to help clarify feelings

Restate the text but keep the meaning


Summarize

When cognitive functioning is diminished, victims of disasters have

difficulty with concise expression of their thoughts and feelings. They repeat

words, phrases, and entire stories—sometimes without a pause. The disaster

relief chaplain may be overwhelmed with the amount of information that is being

related. Summarizing the conversation helps both the victim and the chaplain

briefly recall the basic elements of the conversation.

Echo

Some words have so much power and meaning, there is no synonym,

paraphrase, or summary that would do justice to them. The skilled chaplain will

echo some of these key words or phrases to assure the victim that he or she has

been accurately heard—the chaplain is paying attention to what is important.

Excessive use of echoing will be annoying and may be perceived as mockery.

Reflect

Reflection returns an image to the disaster victim. The chaplain casts back

(as a mirror does) an image of the victim’s story and feelings. Usually, the same

key words and phrases are used. Reflection is the most empathetic form of

listening. The chaplain:

. . . attempts to listen to feelings (as well as words) including feelings

that are between the lines, too painful to trust to words. Now and again

he or she responds to these feelings. . . . [disaster chaplains] listen in

depth, to the multiple levels of communication, verbal and nonverbal,

they reflect back to the person, in paraphrased form, what they hear,

particularly the person’s big (dominant) feelings. This kind of listening

is “disciplined listening”—focusing on what seems to have the most

feeling, meaning, energy, and pain. By periodically summarizing

significant points and asking occasional questions for clarification,

[disaster relief] counselors help persons begin to organize their confused

inner world, . . . ”47

The disaster chaplain who develops skills in reflective empathetic listening

facilitates ventilation of distress in disaster victims. Reflective empathetic

listening avoids false assumptions, misinterpretations, and misjudgment,

identifying deeply with the words, feelings, and meaning of the victim’s story.

Story-Listening—“listening” to the narrative parts of conversations by

using appropriate listening skills and putting them together as a

beginning, middle, and future by giving them significance and meaning

in a life story

Summarize the conversation to briefly recall the basics

An echo gives exact meaning to words and phrases

Reflection is the most empathetic form of listening

Reflective empathetic listening gives strength to the listening process


CRISIS INTERVENTION MODELS48

UNIT 6

Crisis Intervention

In the past, caregivers from many arenas of service have responded to major

disasters; however, many have not been trained for the unique needs and issues

that surround emergency disaster care. Spiritual assessments are completed with

little personal information and history. Spiritual care is provided with a sense of

urgency and for the most immediate need. In most instances, no ongoing care

will occur—the care is instantaneous, urgent, and finite. Victims are often people

of other faith traditions and have no vocational, ethnic, or social alliance with the

crisis responder; thus, the victims have no basis of trust, relationship, or identity

from which they willingly accept care. With greater awareness for the value of

spiritual care in conjunction with physical care during emergencies, the chaplain

in disaster specialization has evolved into a major category.

The growing awareness of spiritual needs in crisis has begun to formalize

the response of chaplains in disasters. National and international disaster relief

agencies are beginning to work together to coordinate spiritual care response in

disasters of many kinds. With technological advances and the globalization of

America, relief agencies have recognized the need to redefine the arena of

disasters. It is no longer only the site/location directly impacted by the disaster,

but now includes remote locations, institutions, and people groups who are in

some way related or impacted by the disaster (e.g., the departure and arrival

airports, the out-of-state corporate headquarters, the home church of the kids in

the bus, the manufacturer and factory of the faulty electrical switch). The need

for spiritual and emotional support far exceeds a disaster site/location or hospital.

When chaplains are not skilled in addressing these issues (and many others that

are equally important49), they fail to provide appropriate ministry to the victims

and often leave the scene feeling inadequate, overwhelmed, or in personal crisis

themselves. Likewise, the victims feel unheard, ignored, discounted, judged, or

even threatened. There is little effective ministry that occurs.

The events of September 11, 2001—the terrorist bombing of the World

Trade Center buildings and the Pentagon—made it exceedingly clear that major

disasters can happen and that there are not enough trained chaplains to meet the

needs of disaster victims. The call to disaster ministry has become evident to

more chaplains and to agencies that respond to crisis.

To minister effectively in disaster relief, chaplains and community clergy

must be aware of the dynamics of the relationships between disaster relief

agencies and must meet the qualifications and requirements of some of these

agencies. One organization that has become a benchmark for crisis intervention

training is the International Critical Incident Stress Foundation (ICISF).

Any chaplain who will intentionally enter the arena of spiritual crisis

intervention in disasters should complete the basic training provided by

International Critical Incident Stress Foundation (ICISF). Today’s training is not

Disaster crisis intervention is a specialized form of ministry

The response of chaplains in disasters is becoming formalized

Major disaster can happen and there are not enough trained chaplains


designed to supplant basic crisis intervention training, but to lay a foundation for

care during and after a disaster. The following sections provide a brief

introduction to the ICISF model of crisis intervention.

International Critical Incident Stress Foundation (ICISF)

“The International Critical Incident Stress Foundation, Inc. (ICISF) is a

nonprofit, open membership foundation dedicated to the prevention and

mitigation of disabling stress through the provision of: education, training and

support services for all emergency services professions; continuing education

and training in emergency mental health services for psychologists, psychiatrists,

social workers and licensed professional counselors; and consultation in the

establishment of crisis and disaster response programs for varied organizations

and communities worldwide.”50

ICISF’s operational manual (3d ed.) states that some aspects of the ICISF

processes include the following:

Provides early intervention

Provides opportunity for catharsis

Provides opportunity to verbalize trauma

Provides a finite behavioral structure

Follows well-structured psychological progression

Employs a group format to address distressing issues

Provides peer support

Provides interactive learning experience to reduce stress

Allows for follow-up

Provides action-oriented intervention

ICISF lists several basic crisis intervention strategies:

Crisis Management Briefing (CMB)

Demobilization

Defusing

Debriefing (Critical Incident Stress Debriefing—CISD)

One on One (1:1)

Pastoral Crisis Intervention

Family Critical Incident Stress Management (CISM)

Organizational Consultation

The ICISF basic model for small group crisis intervention is CISD:

Introduction (safety)

Facts (cognitive)

Thoughts (cognitive to emotion)

Reactions (emotion)

Symptoms (emotion to cognitive)

Teaching (cognitive)

Re-entry (direction)

ICISF is dedicated to the prevention and mitigation of disabling stress

Aspects of ICISF processes

Crisis intervention strategies

Basic model for small group crisis intervention is CISD


Effective Disaster Relief Includes Trained Chaplains as Part of the

Interdisciplinary Team in Disasters and Other Emergencies51

In an age of highly specialized learning and information seeking, it is not

incongruous that organizations, agencies, and people are recognizing the value of

collaboration—“teamwork.” One’s area of focus has become so narrow that one

becomes an “expert” in a particular field without undue concern that one is not

an expert in many other fields. The most practical solution is to join forces with

other experts to implement strategic plans when broader awareness is required.

By effectively delegating responsibility to the most “expert” in the situation, the

output is increased and resources are mobilized to achieve more results.

In a similar manner, disaster relief efforts become more effective when

trained chaplains are a part of the interdisciplinary team. The myriad of possible

needs and complications demands that a team of “experts” in many fields

accomplishes crisis intervention. Mental health personnel may not be able to

address the spiritual needs of victims, and social workers may not be able to

respond to all the cultural needs of the sufferers.

Healthcare institutions have long recognized the value of interdisciplinary

teams in affecting the well-being of their patients. The Joint Commission on the

Accreditation of Healthcare Organizations (JCAHO) announced that patients

have a right to considerate care that considers cultural, psychosocial, and

spiritual values in addition to appropriate medical care. Consequently, the ideal

healthcare team includes professionals from a wide variety of disciplines,

including mental health, social work, and chaplaincy. Patients want a holistic

approach to their care. Holistic care requires the ministrations of an

interdisciplinary team of experts.

Industry standards for crisis intervention methodology, including ICISF,

prioritize the use of interdisciplinary teams in their highly effective approach and

protocols. “The Critical Incident Stress Debriefing team is made up of a

partnership of mental health professionals (master’s degree or higher in mental

health) and peer support personnel who are drawn from the police, fire,

emergency medical, nursing, dispatch, disaster management, and other

emergency-oriented organizations. In addition, most CISD teams also invite

selected members of the clergy [trained disaster relief and crisis intervention

chaplains] to participate on the teams.”52 These teams provide stress mitigation,

critical incident stress recovery, education, prevention programs, and a referral

network.

There is strength in diversity when the goals are alike. Jesus must have

realized that He and His team would be facing many disasters. His team was

comprised of men from many cultural settings and professions. Jesus could have

selected any team; yet He chose diversity—liars, cheats, blue-collar workers,

professionals, the faithful, and the faithless.

There is value in collaboration—“teamwork”

Disaster relief efforts become more effective with trained chaplains on the team

Patients (victims) want a holistic approach to their care

ICISF includes chaplains on their crisis intervention teams

Jesus had a diversified “team”

Summary


The ICISF protocols have been very successful in dealing with the distress

experienced by rescue workers, law enforcement officers, firefighters, and others

who are frequently exposed to critical incidents and traumatic events. These

protocols have also been very effective in providing meaningful interventions for

victims, survivors, witnesses, and others who have been affected by critical

incidents and traumatic events.

The organization advocates for the multidisciplinary team approach and

employs strict criteria for team membership and participation. Southern Baptist

Disaster Relief strongly recommends that any volunteer who intentionally

participates in the disaster chaplaincy ministry also completes the basic crisis

intervention training provided by ICISF.

ICISF has been very successful in crisis intervention


THIS PAGE IS INTENTIONALLY LEFT BLANK


COMPASSION IN CRISIS53

UNIT 7

Demonstrating Compassion Is Being Present in the Suffering

“Compassion is the cardinal virtue of the pastoral tradition, the

indispensable quality that motivates and deepens all charitable, healing, and

caring acts into events of moral and spiritual significance. The compassionate

pastor is therefore one who exemplifies a deeply felt sense of solidarity with

suffering persons transcending class and culture, yet one who maintains the

distance necessary for sustaining suffering persons in their search for an

authentic understanding of the meaning of their afflictions.”54 The chaplain in

disasters must know his or her own biases, needs, and limitations and still deeply

desire to identify with the disenfranchised and the wounded, seeking to

demonstrate compassion as the priority of disaster ministry.

Merely attempting to prevent suffering or not be the cause of suffering will

be inadequate. The chaplain in disasters must approach ministry from a radically

different paradigm—the chaplain must initiate and be an active participant in

“being” compassion as a priority and “doing” compassion as a necessity.

Recognizing his own natural instinct to excuse himself from the crisis, the

chaplain must still choose to become engaged in the suffering. The significance

of being compassionate may lay in the fact that being compassionate is not an

activity one naturally seeks, but an activity that one must intentionally choose,

knowing that it “feels” contrary to natural instincts.

There is a natural resistance humans have toward pain—one avoids it

whenever possible. The emotionally healthy individual does not intentionally

cause oneself unnecessary pain. One naturally seeks safety, shelter, and

nourishment as self-preservation before seeking to meet the needs of others.55

Therefore, one must be aware that choosing to serve as a chaplain in disasters

will not be for everyone. Only a few will choose to enter this place of suffering

with victims of disasters—often these victims will be strangers, and sometimes

they will be the perpetrators of the disaster itself (e.g., the Colorado wildfire

arsonist became trapped and became a psychologically traumatized victim). For

chaplains serving in disasters, the response of “being present in suffering” is an

intentional choice to be uncomfortable. Such intentionality is spawned by a

sense of call to this kind of demanding ministry. The choice to accept the

uncomfortable conditions related to this kind of caring also grows out of the

center of the chaplain’s personal feelings and emotions— from one’s “guts.”56 A

sense of duty or dedication to service often enhances these inner drives and

forms a powerful motivation for the chaplain “to weep with those who are

weeping” (Romans 12:14-21), even when it may feel very awkward to do so.

Demonstrating compassion is an act of intention and an intention to act. It

is intentionally entering a place of crisis and full immersion in the human

condition. Demonstrating compassion may be risky.

Compassion is being completely present in the suffering of another

One must intentionally choose to be compassionate

Caregiving during and after disasters will not be for everyone

“Being present in suffering” is an intentional choice to be uncomfortable

Demonstrating compassion may be risky


What kinds of disasters will be uncomfortable for you? Why?

What kinds of disasters might be uncomfortable for you? Why?

What needs to happen for you to be able to give yourself permission to decline

participation in the crisis intervention? “The need” does not constitute “the call”

Demonstrating Compassion Is Being Sensitive to Human Diversity

Chaplains in disasters will be called upon to demonstrate compassion by

being sensitive to human diversity. While they are not called to compromise

their own faith, traditions, and culture, they will be called upon to minister to

victims from diverse people groups.57 They must be aware of their own

assumptions, faith, and practices, and be aware of the history and environment

that have informed them. They will be called upon to expand their worldview to

include the view from eyes of different colors, shapes, and heritages. They will

be invited to contextualize the faith expressions of those they encounter,

understanding that cultural settings affect the way people think, act, and feel.

Chaplains in disasters must integrate ethnic variations in dying, death, and grief

into their own personal traditions, adopting new paradigms for “normal” grief,

woundedness, and loss.

As cultural diversity awareness increases, caregivers will face the challenge

of becoming more open to differences. Chaplains in disasters will face the

challenges of providing caring interventions to people who are different—not just

different in religion, skin color, or language, but to people whose political

alignments are contrary to one’s own, to people whose moral standards are

personally questionable, to people who are the outcasts of society, to people who

are criminals, to people who are arrogant, disgusting, unappreciative, or hostile.

Chaplains in disasters will be called upon to demonstrate compassion by being

sensitive to human diversity.

As a minister in an environment of differing cultures, interests, and

religions, the chaplain must be informed about a multiplicity of faith groups and

seek ways to allow all people to express their faith or lack of faith in meaningful

ways, understanding without compromising his or her own faith. Without

coercion or force, the Christian chaplain evangelizes the world through his or her

own character, integrity, compassion, and witness. As chaplains minister to the

spiritual needs of people, they engage in spiritual conversations that often lead to

opportunities to share their personal faith and religious beliefs. When direct

evangelistic conversations don’t materialize, Christian chaplains do pre-

evangelism—laying the foundation for future opportunities to share the gospel.

Chaplains in disasters must expand their worldview

Cultural diversity is more than differences in religion, skin color, or language


They demonstrate true compassion, genuine interest in the lives of their clients,

and agape love for all people. In the words of St. Francis of Assisi, chaplains

must “Preach the Gospel at all times and when necessary use words.”58

How might your cultural background influence the way you provide care in

disasters?

How does your culture strengthen your chaplaincy ministry?

What are some weaknesses you have noticed in the way you provide care based

on your cultural influences?

Demonstrating Compassion Is Providing the Ministry of Care in Crisis

The chaplain in disasters who acts exclusively out of duty and fear is subject

to an unhealthy attitude that results in resentment when people do not appreciate

the “help” or burn-out when people expect more than is offered. This is called

servitude—an attitude of the slave, forced into involuntary labor. Kenneth

Haugk differentiates the attitude of servitude with the attitude of servanthood.

Chaplains in disasters are called to a ministry of servanthood, which

includes empathy while maintaining personal identity; genuineness by acting

congruently; meeting needs, not wants; and intentionality in entering caring

relationships. The person with the attitude of servitude will over-identify with

the problems of the victims, compensate for frustration and anger with

superficial sweetness, allow himself or herself to be manipulated, and provide

care begrudgingly while complaining. The chaplain in disasters who operates

out of an attitude of servanthood does so out of commitment and love.59

The attitude of servanthood demonstrates itself by providing encouragement

to those who are fearful or sad. Victims feel helpless and the chaplain empowers

victims through the encouragement of listening and comforting. Victims are

empowered to move forward from crisis to healing.

The ministry of care means meeting immediate needs. Sometimes,

compassionate care is providing food or water, medical care or shelter. The

chaplain in disasters will be a part of a multidisciplinary team, meeting

immediate needs and providing assistance in the chaos.

Articulating the love and concern of God may be the most powerful

component of providing the ministry of care in crisis. When chaplains offer

prayerful intercession, many victims feel comforted and encouraged.

“Servanthood,” not “servitude”

Love motivates servant ministry compassion

The ministry of care provides encouragement

The ministry of care meets immediate needs

Personalized, spontaneous prayers are comforting


Personalized, spontaneous prayers are a demonstration of compassion.

...the pastoral crisis interventionist [disaster relief chaplain] benefits from

the ability to use, where appropriate, scriptural education, insight, and

reinterpretation (Brende, 1991), individual and conjoint prayer, a belief

in the power of intercessory prayer, a unifying and explanatory spiritual

worldview that may serve to bring order to otherwise incomprehensible

events, the utility of ventilative confession, a faith-based support system,

…and in some religions, such as Christianity, the notion of divine

forgiveness and even a life after death. All of these factors may make

unique contributions to the reduction of manifest levels of distress

(Everly & Latin, 2002).60

Compassion at the Scene

What to Be

Demonstrating compassion at the scene of a disaster has some very practical

implications. To be compassionate towards the victims of disasters, the disaster

chaplain must:

Be there

Be near

Be attentive

Be willing

Be compassionate

What to Have

Each disaster relief organization or agency has equipment requirements for

caregivers. Some agencies, such as the Red Cross, provide “Go Boxes” which

contain many helpful (and sometimes necessary) implements for care. All

chaplains in disasters must have proper equipment. Some basics would include:

Proper clothing—clerical garb if appropriate, long pants or skirts (no

shorts or minis), layers for warmth, walking shoes or boots

Identification—official disaster response team ID, driver’s license or

passport, disaster agency ID, credentials

Telecommunication apparatus—cell phones, pagers, walkie talkies,

PDAs

Large fanny pack or small backpack

Emergency equipment—flashlight, batteries

Snacks

Personal medications for the first 24 hours

Small note pad and pen

Religious articles consistent with our faith as Southern Baptists (i.e.,

Bible, prayer cards)

Chaplains in disasters are strongly cautioned by their own response teams

regarding proper and improper equipment. Cameras are almost universally

Chaplains must “be”

Chaplains must have proper equipment

Be prepared


considered inappropriate. Spouses and other family members should not be

brought to the disaster scene. Anything that is bulky will be difficult to manage

and should be avoided. Chaplains will be on the disaster scene and the site may

be cold, wet, dirty, dangerous, crowded, or dark. It is best to be prepared.

What to Say

Faced with disaster and the reactions of victims, some chaplains admit they

“don’t know what to say.” This is true in many situations and is not unusual.

Answer questions directly and truthfully. When in doubt, admit that you are not

sure. Inform the victim that you will try to locate the answer as soon as possible

and permissible. Chaplains often need to say very little, but what they choose to

say needs to be relevant. Listen more than talk and try to empathize with what is

said. Be sure to let your words reflect the compassion that compelled you to be

present.

Victims may ask various kinds of questions in response to a disaster (see

pages 62, 63, 66, 67). People are usually confused and disoriented in the

aftermath of disaster and may ask questions such as “What happened?”, “Am I

safe?”, “Where is . . .?”, “Have you seen . . .?”, “Where am I?” These are the

opportunities for the chaplain to provide comfort and encouragement by

clarifying the situation, finding interpreters, and saying with the eyes and heart

what cannot be said in words.

In addition to answering basic factual questions, the chaplain is often called

upon to console and provide support as individuals try to process deep concerns

or questions about life and death that sometimes are raised by critical events.

Short, clear answers are better. Remember, cognitive functioning is diminished

and long explanations will probably not be understood or retained. In attempting

to give brief answers, one can seemingly generate responses that are

oversimplified. Oversimplified answers may be perceived as hollow or shallow

to a person impacted by crisis. Be prepared to embrace their reactions and

expand on certain ideas as there is a need and opportunity to do so.

In particular, trying to answer “Why” questions can be counter-productive

since the victim is usually manifesting a symptom of shock with such inquiries,

not necessarily seeking philosophical truths. The chaplain should not ignore or

avoid these kinds of questions because the person may need validation that it is

permissible to ask such questions. The chaplain is the key responder in a group

of care providers who is expected to have thought significantly about such

matters by the very nature of their role as a spiritual care agent (see pages 65,

66). Be careful not to impose your answers on the victims but seek to help them

explore questions and discover answers that will satisfy the yearning in their

soul. One important suggestion would be to indicate that the thoughts you share

are helpful to you and are offered with hope that they will also be helpful to the

one who has experienced the disaster. As you build trust with people in the

process of listening and offering meaningful feedback, they will often become

more interested in your insights and guidance.

Occasionally, chaplains must answer questions from victims concerning

their family members or friends involved in the disaster. This can be quite

Listen more than you talk

Keep your answers simple

Tell the truth

Provide clarification

Communicate with your eyes and heart

Do not blurt out bad news


overwhelming, even for the chaplain. This kind of information should never be

shared without proper authorization from appropriate levels of leadership.

Provide this kind of information in a protected setting where victims are shielded

from public view. Have as much available support in proximity as possible.

Give news in small doses, preparing the victim for the next bit of information.

Such preparation for bad news helps the victim hear and accept what would

otherwise be too shocking to receive.

What to Do

One of the greatest frustrations that disaster relief workers face is the

seeming impossibility of doing something. While the task of the chaplain is not

necessarily one of doing rescue, chaplains can be very helpful in providing

assistance by meeting basic physical needs, helping with practical decisions, and

allowing victims to spend time with their loved ones. Chaplains can help

facilitate communications by assisting with phone calls or providing directions

and clarification.

When requested, chaplains can provide the unique elements of spiritual

care—prayer and religious rites and rituals. Some requests will be for general

spiritual care. Other requests may require specific religious observances.

Chaplains may be able to provide these specific religious interventions or they

may find others who will.

Chaplains may help victims by providing practical help

Victims may ask for specific religious interventions

Compassion Fatigue

Compassion fatigue results when caregivers experience a trauma event

through listening to the story of the event or experience the reactions to the

trauma through empathetic contact with victims or survivors and are unable to

distance themselves from the event. Compassion fatigue is trauma-specific and

the symptoms are similar to post-traumatic stress disorder (PTSD).

Charles Figley identified compassion fatigue as a secondary form of post-

traumatic stress in Compassion Fatigue. It is the costly result of providing care

to those suffering from the consequences of traumatic events. Professionals

especially vulnerable to compassion fatigue include chaplains and other helping

professionals—emergency services personnel, mental health professionals and

counselors, medical professionals, clergy, victim advocates and assistants, and

human services personnel.

Reactions to Long-term Stress

“Burnout”

Burnout is the most obvious reaction to long-term stress. Burnout is

emotional, mental, and physical exhaustion that occurs when several events in

succession or combination impose a high degree of stress on an individual.

Burnout could happen to the healthiest of chaplains.

Chaplains may experience compassion fatigue through empathetic contact with victims

Burnout is emotional, mental, and physical exhaustion


Contributing factors in disaster chaplaincy burnout include:

Professional isolation

Emotional and physical drain of providing continuing empathy

Ambiguous successes

Erosion of idealism

Lack of expected rewards61

Feeling obligated instead of called

Maintaining an unrealistic pace

Poor physical condition

Continuous rejection

Human finitude

Symptoms of burnout include:

Isolation

Depression

Apathy

Pessimism

Indifference

Hopelessness

Helplessness

Physical exhaustion

Irritability

Cynicism

Short temper

Negative attitudes

Countertransference

Chaplains in disasters are emotionally involved with many hurting people.

Emotional involvement comes from the very nature of being present to victims,

relief workers, and survivors. Empathetic listening and compassion create the

environment that causes chaplains to vicariously share the trauma of disaster

victims. Suffering on behalf of another person causes the chaplain to return to a

place of hurt and disappointment—perhaps even severe trauma—in his or her

own life. When countertransference occurs, the chaplain becomes a victim,

needing the same post critical incident interventions as the primary victims.

Experiencing the same sights and sounds of a previous critical incident may

cause countertransference. Some similarities that result in countertransference

include:

Past experience—The traumatic event causes the new crisis. Chaplains

must be aware of their own history and experience. Those who have

experienced similar critical events or trauma will be more likely to relive

his or her previous experience through the current critical event.

Personal identification—The similarities between the victim and the

chaplain cause the new crisis. Personal identification may be a plus for

the victim as he or she seeks safety and security (trust), but that same

personal identification may be a minus for the chaplain who becomes

There are many contributing factors in burnout

Symptoms of burnout vary

The empathetic chaplain becomes a victim vicariously

Countertransference may result from past experience, personal identification, or physical fatigue


overly identified with the victim’s crisis. Personal identification may

result from a perceived relationship due to ethnic heritage, gender,

profession, language, or nationality.

Physical fatigue—When chaplains are physically exhausted or out of

shape, they are unable to cognitively function at their highest levels.

They tire easily, have a low resistance to excessive emotional

involvement, and have difficulty separating the victim’s experience from

their own past and present experiences. Consequently, empathy grows

and personal identification becomes more intensified, resulting in

countertransference.

Changes in Values and Beliefs

One of the chief characteristics of a critical incident—disaster—is the

inevitable change it causes. The changes may be positive or negative. Victims

may experience doubt and uncertainty regarding physical survival—this was an

expectation pre-critical incident. They may become fearful about their safety

and security—this was probably a non-issue prior to the trauma. They may

become less trustful of people, institutions, and/or God. That which was held as

sacred may have been desecrated. One’s determinations about reality and how

to best perceive it may have been altered or become distorted. Conversely,

victims may also become more interested in spending time with family,

considering matters of faith, or participating in religious activities. Some changes

are very temporary and victims return to pre-incident levels of functioning within

a relatively typical time frame.

When chaplains are subjected to disaster response conditions such as mental

and/or physical exhaustion, long-term stress, countertransference, and burnout,

they may also experience changes in their values and beliefs. As with victims,

such change may be positive or negative. Chaplains may be overwhelmed by the

conditions of the crisis with its resulting stressors and begin to interpret all of life

based on the reactions or implications of a single event and its related

experiences. In this sense, one becomes myopic and can only view reality

through one set of lenses—disaster lenses. This may also be referred to as a form

of “tunnel vision.” Ordinary activities pre-critical incident may lose their sense

of meaning and purpose when compared to the circumstances surrounding the

disaster victims.

In order to remain effective in the disaster setting(s) and upon returning to

one’s own personal surroundings, the chaplain must choose to reframe his or her

understanding of the crisis event(s) by effectively incorporating such experiences

into a broader perspective of life and a corresponding Christian worldview

(consistent with meaningful ways to comprehend what is real, true, good, and

what determines appropriate and inappropriate responses). This can lead the

chaplain to appreciate and cherish (not take for granted) the simple aspects of

daily living such as having a home, sharing a meal with family or friends, or

taking time to play with a child. This refined understanding precipitated by the

“reality check” often accompanying a disaster can help the chaplain (and those

he or she is able to help) avoid the temptation of being seduced by the

perspective and ongoing pressures of a life untouched by tragedy.

Critical incidents may cause chaplains to experience changes in their values and beliefs

Signs and symptoms of compassion fatigue are similar to those of PTSD


Signs and Symptoms of Compassion Fatigue

Compassion fatigue is preoccupation with the victim or cumulative trauma

of victims, emotionally re-experiencing the traumatic event, and persistent

arousal. Those suffering the effects of compassion fatigue absorb the trauma

through the eyes and ears of the victims to whom they provide ministry.

Some indicators of compassion fatigue include:

Nightmares, dreams, or disturbing memories of the critical incident

Emotional numbing

Feelings of despair and hopelessness

Feelings of isolation, detachment, estrangement

Disconnection from loved ones, social withdrawal

Increased sensitivity to violence

Avoidance of thoughts and activities associated with the incident

Increased and persistent cognitive dysfunction—difficulty concentrating

In the final analysis, there is a cost associated with compassion fatigue—

performance declines, mistakes increase, morale drops, health deteriorates, and

personal relationships are at risk. The cost is more than physical, it is emotional,

cognitive, social, and spiritual.

Basic Self-Care

Effective spiritual care intervention during disasters begins with preventive

maintenance. Chaplains must initiate good lifelong habits of self-care. This

includes a well-balanced diet, regular physical exercise, significant relationships,

and awareness of spirituality. Effective self-care means taking care of yourself

before, during, and after the disaster intervention.

Preventive maintenance includes:

Reduce refined sugars, caffeine, fats, alcohol, salt, cholesterol

Increase cardiovascular exercise

Eliminate smoking, chewing tobacco, and unprescribed drugs

Use relaxation techniques (e.g., deep breathing, meditation, prayer)

Maintain healthy relationships with loved ones and associates

Critical events (disasters) cause distress and crisis intervention is distressful. Disaster relief chaplains must take the initiative to mitigate their own stress

during the trauma. Education and practice (training) will help facilitate self-care

during the crisis.

Self-care during disasters may include:

Taking regular breaks

Working in established shifts or rotations

Compassion fatigue has a high cost

Basic self-care begins with preventive maintenance

Self-care must be maintained during the disaster


Working in teams (for support)

Catharsis with other disaster relief chaplains

Self-care after the critical incident (disaster) might include a thorough

debriefing with the response team. This might take the form of a formal CISM

group intervention or might take the form of an informal “lessons learned”

discussion.

Reconnecting with loved ones, engaging in hobbies and interests, learning

new skills, personal reflection, laughter, and days off will help restore the typical

ebb and flow of pre-disaster life. Prayer, reading Scripture, participating in

corporate worship, sharing your experiences during formal or informal speaking

opportunities, inspiring new volunteers, and other spiritual interventions help

provide healing and respite for the weary chaplain.

What are some ways you are doing preventive self-care?

What self-care interventions seem most helpful to you when you are in a stressful

situation?

Self-care must be an ongoing process


COMFORTING GRIEF IN DISASTERS62

UNIT 8

Elements of Grief

Defining Grief

Grief is emotional distress that is caused by perceived loss. The loss may be

physical, relational, spiritual, or intrapsychic. It is very much like a wound or

illness that needs to be healed. Grief is very different than mourning, which

follows the recognition of loss and is the beginning of the healing process.

Mourning is often defined as the cultural or public display of grief but is, in fact,

the work of healing.

A Picture of Grief

Although there is no right way to grieve, there are characteristics that seem

very common to those who are grieving. William Worden suggested that there

are four general manifestations of normal grief: feelings, physical sensations,

cognitions, and behaviors.

A Snapshot of Feelings Sadness, anger, guilt, shock, helplessness, self-reproach, confusion,

relief, yearning, anxiety, fatigue, loneliness, numbness, alienation,

despair, hopelessness, emancipation, fear, feeling out of control

A Snapshot of Physical Sensations Tightness in the chest or throat, oversensitivity to noise or light,

breathlessness, weakness in the muscles, hollowness in the stomach, lack

of energy, sense of depersonalization, loss of sexual desire,

gastrointestinal disturbances, heart palpitations, dry mouth

A Snapshot of Cognitions Disbelief, confusion, preoccupation, sense of presence, hallucinations,

slow thinking, loss of memory, poor concentration, sense of going crazy,

space and time confusion, sense of “nothing seems real, including me”

A Snapshot of Behaviors Sleep disturbances, appetite disturbances, absent-mindedness, social

withdrawal, dreams of the deceased, sighing, crying, restlessness,

avoiding places and people, treasuring objects that belonged to the

deceased person, disorganization, escaping by over-commitment to

work, searching and calling out, restless over-activity, visiting places or

carrying objects that remind the survivor of the deceased

Grief is emotional distress that is caused by perceived loss

Grief manifests itself in feelings, physical sensations, cognitions, and behaviors


Think about the most painful loss you have experienced . . . what were your

1. Feelings?

2. Physical sensations?

3. Cognitions?

4. Behaviors?

5. Spiritual concerns?

What manifestations of grief would be difficult for you to experience?

Losses that Lead to Grief

Your own experiences

Physical “Things” (house, car, property, mementos, “valuables”), health, vision,

hearing, mobility, limb, talent, reproductive organs, body parts,

“beauty,” physique, image, memory, cognition, speech, smell, taste,

feeling sensation, 401k, trusts, bonds, stocks, money, pets, resources,

financial support, “innocence” (sexual assault, incest), job, business,

income

There are many losses that lead to grief: physical, relational, spiritual, and intrapsychic

Relational Spouse, children, siblings, parents, fiancé, step-children or step-parents,

foster children or foster parents, in-laws, grandparents and

grandchildren, extended family, friends, coworkers, peers, colleagues,

teachers, clergy, employers, employees, teammates, institutions,

professions, careers, licenses, jobs, clubs or associations, independence,

influence, marriage, significant relationships, friendships, way of life,

trust (infidelity), children leaving home, belongingness

Spiritual Faith in God, faith in religion, trust in clergy, trust in church or religious

organization, value system, credibility, integrity, traditions, sense of

worthfulness, identity, meaning of life, time, history and connections to

the future, hope, values, will to live, belovedness, love


Intrapsychic Plans for the future, deferred dreams, missed opportunities, important

image of oneself, self-esteem

Special Losses Suicide, miscarriage, sudden infant death (SIDS), death of a child, still

birth, abortion, AIDS, homicide, genocide, execution, mass murder,

terrorism, war, MIA’s, multiple deaths, Alzheimer’s, mental retardation,

victim-perpetrator

Special losses complicate the grief process

Grief Is a Process

There has been much written describing the grief response. One has

described grief in stages, another as tasks, and another as process. Because grief

is extremely personal, it is unique to each individual. Chaplain Tim Van

Duivendyk, director of Pastoral Care and Clinical Pastoral Education at

Memorial Herman Hospital, has described the grief response as Wilderness

Wandering. The journey through grief frequently returns to familiar places of

pain and healing. As such, perhaps process is the most accurate description of

the grief response. No loss is experienced in a vacuum and likewise, no grief is

expressed without the influence of environment and circumstances. The process

of grief is dynamic—like the sea, it ebbs and flows, then moves on.

A comparison of several notable theories regarding the grief response might

be helpful.

Elizabeth Kubler-Ross—Five Stages of Grief—in On Death and Dying,

196963

1. Denial and isolation

2. Anger

3. Bargaining

4. Depression

5. Acceptance

J. William Worden—Four Tasks of Mourning—in Grief Counseling and

Grief Therapy, 1991

1. To accept the reality of the loss

2. To work through the pain of grief

3. To adjust to an environment in which the deceased is missing 4. To emotionally relocate the deceased and move on with life

Wayne E. Oates—The Grief Process—in Pastoral Care and Counseling

in Grief and Separation, 1976, states that Kubler-Ross’s five stages are

preceded by three other factors

1. Shock

2. Panic

3. Numbness

Grief is a process in response to loss

Kubler-Ross—Five Stages of Grief

Worden—Four Tasks of Mourning

Oates—Three predecessors


T.A. Rando—The Six R Processes of Mourning—in Treatment of

Complicated Mourning, 1993

1. Recognize the loss

2. React to the missing 3. Recollect the missing, the relationship, and the meaning of the

relationship

4. Relinquish attachments to the world before the loss including

assumptions that no longer hold

5. Readjust to a new world without forgetting the old

6. Reinvest in the world around you

.

Drawing on these models, the grief response may be portrayed as a journey

of three parts: 1) acknowledging the reality of loss (shock and denial), 2)

expressing the pain of grief, and 3) moving toward acceptance. In the initial

moments of the journey, the victim wanders through the shock and denial of

trying to acknowledge the reality of the loss. As the reality of the loss is

embraced, the victim then begins to express the pain associated with that grief

and loss. There are physical, emotional, relational, and spiritual symptoms.

After revisiting places of pain and healing, perhaps even still denying the reality

of the loss at times, the victim struggles through a resistance toward acceptance,

moving on, and hope.

No two journeys are the same and each journey takes a unique amount of

time to travel. Perhaps one never arrives, but one draws closer to acceptance,

always seeking to move forward in the ventures of processing grief. The journey

is a spiral rather than a circle. Each round moves higher and higher. Sometimes,

the round retreats and grief plunges one again into great depths of pain and

sorrow. For most people, the acute pains of grief diminish and hope appears in

the future.

1. Acknowledging the reality of loss

Shock, numbness, denial—Worden’s Task #1

Shock, panic, numbness—Oates’ three factors preceding Kubler-

Ross’s stages

Denial and isolation—Kubler-Ross’s Stage #1

2. Expressing the pain of grief and loss

Physical symptoms

o Crying, aches, pains, illness

o Lack of energy or uncontainable energy

Emotional symptoms

o Sad, mad, glad

o Anger—Kubler-Ross’s Stage #2

Relational symptoms

o Bargaining, blaming, fighting, clinging, sudden

appreciation

o Bargaining—Kubler-Ross’s Stage #3

Spiritual symptoms

o Temptation, guilt, shame o Increased awareness of human/divine, faith, dependence

on God

Rando—Six R Processes of Mourning

Grief—a journey from shock to acceptance


3. Moving toward acceptance

Desire to live more in the present and future than in the past

Willingness to explore new relationships and activities

Renewed energy that overcomes the gloom of doubt and despair

Resistance

o Worden’s Task #1—to accept the reality of the loss

Struggle

o Worden’s Task #2—to work through to the pain of grief o Worden’s Task #3—to adjust to an environment in

which the deceased is missing

o Depression—Kubler-Ross’s Stage #4

Hope

o Worden’s Task #4—to emotionally relocate the

deceased and move on with life

o Acceptance—Kubler-Ross’s Stage #5

The grief process will also be affected by the circumstances of death. In

disasters, death tends to cause “traumatic grief.” Grief is a result of sudden,

unexpected, or random death. Survivors must deal with the critical incident

stress issues surrounding a traumatic event before they can begin processing the

individual loss of life. There is no preparatory period during which survivors

begin to plan for loss and grief. The unexpected nature of the loss tends to cause

more anger.

Draw a diagram of your grief journey:

Critical Event

In disasters, death causes “traumatic grief”

My personal grief journey


Comforting Grief

Grief takes many forms and requires informed compassionate care.

Comforting the grieving victim of disasters requires great sensitivity.

Understanding the emotional upheaval that is being experienced is critical to

providing effective ministry. As the chaplain prepares for disaster response, it is

helpful to remember that the chaplain in disaster must be present to the suffering

of those who grieve.

First, they must be physically present. In response to disasters, chaplains

must 1) be there, 2) be near, and 3) be attentive. To help victims feel safe and

more secure, physical presence is essential.

Secondly, chaplains must be emotionally present. They must listen and

empathize as spiritual acts. Empathetic listening assures the victim that grief

words and grief feelings are being heard.

Thirdly, chaplains must share practical presence. Helping with practical

decision making and daily duties is a demonstration of compassionate presence.

Chaplains are present to meet immediate needs while providing encouragement.

And, chaplains provide the spiritual presence that is unique in the ethos of

chaplaincy. Through prayer and prayerful attitudes, chaplains provide the

presence of God in the midst of grief.

Being present and being compassionate will be more than adequate. Listening to the grief story and talking, specifically remembering the loss and

calling it by name, and being open and accepting of all the emotions and tears of

grieving will provide the comfort that begins to offer hope for another day.

The ministry of presence is a comfort in grief

Complicated Mourning

There are some situations in which the process of grief becomes very

complicated. Usually, these circumstances are considered “special losses.”

Many of these situations do not result in the physical death of a person, and the

circumstances surrounding the loss are significant, unique, or extremely

traumatic.

These special losses may be categorized as follows:

Disenfranchised loss

Suicide (victim is the perpetrator), death of “significant other,”

AIDS, deceased is the cause of an accident resulting in death,

deceased was involved in criminal activity, deceased was involved

in immoral or unethical behavior at time of death, impotence,

abortion, miscarriage, rape, incest

“Special losses” often complicate mourning

Categories of special losses


Unexpected, sudden death

Accidents, disasters

Death perceived as preventable

Homicides

Murder, manslaughter

Suicide (revenge, protest, terrorism, mercy)

Mass murders

Vehicular homicide

Complicated homicides

- Sexual assault

- Torture

- Dismemberment after death

- Mutilation

- Delayed execution Genocide (destroying an ethnic, national, or religious group)

Terrorism

Vanished (kidnapped, “missing,” MIA’s)

Multiple deaths during short time frame

Line of duty deaths

History

of anger with the deceased

of major stress and crisis

of emotional and mental problems

Marked dependent relationship with the deceased

(primary caregiver)

Lack of social support

When grief is a result of circumstances that are extraordinary, it is possible

that complicated mourning will occur. This may intensify typical grief reactions

as a result of the critical incident stress that occurs.

Lessons Learned

During disaster response, there is little time to think about appropriate responses

and words of comfort. From the field, there are some practical lessons in the

form of “Do’s” and “Don’ts.”

DON’T…

Avoid the grieving person

Assign guilt or blame

Address “Why?” questions without necessary precautions (see page 50)

Minimize the loss

Change the subject away from the deceased

Grief reactions are intensified

Lessons learned in the field are practical helps

DON’T…


Try to talk too much

Say: “I know how you feel”

“It was God’s will”

“(S)he’s in a better place now”

“Time heals all wounds”

“Be brave”

“Don’t cry”

“He’s at rest”

“The Lord knows best”

“Be glad it’s over”

“You need to be strong for…”

“Call me if you need anything”

DO… Acknowledge the loss, specifically

Give permission to grieve

Listen non-judgmentally Allow the grieving person to talk about the deceased

Ask open-ended questions about the event

Offer practical assistance

Empower with small choices and decisions Share words of admiration for the deceased, if appropriate

Say: “I’m so sorry”

“I’m sorry for your loss”

“I cannot begin to understand your pain, but I’m here for you”

“Would you like to talk?”

“(Name of deceased) loved you so much” “May your God bless you and give you strength”

“I am grieving with you about ’s death”

“I know you are going to miss ”

DO . . .

What are some lessons you have learned when responding to death and grief?

What was the most helpful thing someone did for you when you were grieving?

What was the least helpful thing someone did for you when you were grieving?


SPIRITUAL DIMENSIONS OF TRAUMA64

UNIT 9

Overview of Spirituality in Trauma

Traumatic events are an attack on meaningful systems. Spirituality helps to

define people’s value systems and understanding of being (existence),

nothingness (non-existence), relationships, time and eternity, life, and death. Victims of traumatic events usually reexamine their beliefs and values in terms

of the crisis event. Faith may be rejected, transformed, or unchanged

(reaffirmed).65 Stress and distress affect one’s spirituality, and conversely, spirituality affects one’s stress and distress.

In addition to the positive effects of crises on spiritual well-being like

clarity of mind, value definition, and revitalization of faith, there can also be a

negative impact. “Horrific traumata destroy spiritual well-being.” 66 Deep

spiritual losses of hope, future, innocence, and trust often result in post-traumatic

shock disorder. Many individuals instinctively seek spiritual support in crisis.

They have a hopeful expectancy that prayer, spiritual guidance, and sacraments

will be helpful in alleviating their pain or sense of loss. Others may not be

specifically desirous of spiritual care but are psychologically receptive to

spiritual care.

There is much evidence of the effectiveness of religion or spiritual faith in

coping with trauma. Medical professionals and scientists recognize the positive

effects of faith in responding to physical and emotional distresses.

Consequently, chaplains are quickly dispatched to disasters and other traumatic events. By incorporating spirituality in the crisis response, physical healing increases, mortality rates decrease, depression decreases, and there is a positive

effect on diseases, ranging from cervical cancer to stroke.67

Trauma victims often benefit from spirituality and religion as they attempt to

adapt to the crisis event. Marlene Young lists several compelling arguments for

using chaplains to mitigate distress in the crisis event:

Causal explanations of trauma are a function of religion and abnormal

events trigger religious attributions

Religion is used as emotional support and assists cognitive structuring

Religion is used by victims to cope emotionally and solve problems

The potential of religious assistance is a positive operative force in

coping

Measures of religiosity are strong predictors and positively relate to the

quality of life

Prayer, in the religious sense, may be a source of ventilation and

validation for people of faith

Prayer serves as a source of stress moderation

Prayer is a form of spiritual processing 68

Traumatic events cause people to reexamine their beliefs and values

Spiritual faith has a positive effect in responding to distress

There are compelling reasons to use chaplains in crisis events


Whether the crisis is loss of property or death, faith is reexamined in the

light of one’s spirituality. Personal values and beliefs may be shattered or

transformed. Assumptions about life and death, people and God, good and

evil—all may be challenged and redefined. Crisis shakes the very foundation of

one’s being, and spirituality redefines hope and the future.

From a Christian perspective, there are benefits of using chaplains in crisis

events that go beyond the list Marlene Young has provided. Chaplains are a

reminder that God is aware of and present to victims in their distress. The living

person of Jesus shares the struggle each victim encounters during crisis and

trauma. If faith is being reexamined, chaplains have opportunities to clarify false

assumptions and demonstrate true hope for the future.

Critical events redefine one’s spirituality

God is aware and present to the victim in traumatic events

Role of Religion and Spirituality

Spirituality is the essence of life—the beliefs and values that give meaning

to existence and that which is held sacred. It is one’s understanding of self, God,

others, the universe, and the resulting relationships. Spirituality is the

understanding, integration, and response to the transcendent.

How do you define “spirituality?” How do you define “spirituality?”

Religion could be defined as the operational system of personal or

institutional beliefs and practices that intersect with the transcendent within a

cultural or social setting. Religion guides the understanding, integration, and

response to the transcendent through participation in and with an organized faith

community with shared beliefs, practices, and rituals.

How do you define “religion?”

During and after a critical event—disaster—victims often appropriate

religious and spiritual mechanisms to mitigate the enormity of crisis they are

experiencing. Many times, the victim is not aware of using the mechanisms.

Coping—In their fight for survival, victims use spirituality and religion

to cope with the crisis situation until the crisis abates.

Healing—There is clinical evidence that religion and spirituality have

positive preventive and healing effects on diseases and emotional

distress.

How do you define “religion?”

The role of religion and spirituality in trauma


Support—Victims use the mechanics or institutions of religion to

provide emotional support in dealing with the emotional trauma of

disasters and death. The availability of God or clergy or religious

institutions provides spiritual and emotional support during crisis.

Questions—In the chaos and confusion that results from disasters,

victims have a need to make sense of the traumatic event. In doing so,

spirituality and religion provide the tools for asking questions and

problem solving.

Seeking—As victims seek answers and understanding, religion and

spirituality provide the mechanisms for searching and seeking.

Stress mitigation—Prayer provides a “listening ear” during crisis. It

allows the victim to vent his or her crisis as a hopeful response. Prayer

provides an avenue for processing the chaos and reducing the stress

through repetition, communion, and meditation.

Connecting—Prayer and spiritual activities help victims connect with

others and God (see pages 3, 4). Such activities bring people into a

shared setting where they can receive encouragement and guidance for

integrating “the present crisis” with both the past and the future. By

joining memories of past accomplishments, fond experiences, and old

traditions with the hope of progress, the promise of future memories, and

new traditions, people realize they are not alone on the path of dealing

with the given crisis.

Spiritual Issues and Questions from Victims and Survivors

After critical events—disasters—victims and survivors ask many spiritual

questions (see page 50). After September 11, 2001, these questions became

common topics at meals, gatherings, and seminars. The questions are difficult

ones and chaplains rarely have adequate answers. It is both acceptable and

necessary to ask these questions. It is equally important for the chaplain to hear

and validate the questions without the necessity of an answer. In asking the

questions, victims and survivors begin the journey of mourning that which was

lost.

Why did this happen to me?

Why did have to die?

Why didn’t God take me instead?

Did God do this to punish me?

Does this mean I owe God my life now (now that I survived)?

Why does God make so many good people suffer?

Why does God let bad things happen?

Why did God hurt little kids?

I want to die . . . why can’t I just die, too?

Whose fault is this?

Is (the perpetrator) going to be punished for this?

Why doesn’t God answer my prayers?

How will I know if God is telling me something?

Why does God allow evil in the world?

Victims and survivors ask difficult questions . . .


Who keeps God in line?

Is there life after death?

Is there really a heaven?

Will (the perpetrator) go to hell for this?

What did I do to deserve this?

Did God choose me to suffer for some special reason?

What good can come out of this suffering?

Is there anything I can do to make God stop doing this?

What’s there to live for?

Why can’t do something to stop this?

Am I special because I survived and didn’t?

What’s expected of me now (that I survived)?

What questions would you ask if you were a victim or survivor?

What would you ask?

Religious Coping Styles

When people are in crisis, religion and spirituality are essential in helping

them cope during intense arousal. Emotions have reached extraordinary levels

and cognitive functioning is low. In these situations, victims rely on their faith to

help them make sense and meaning in chaos.

Disaster chaplains may be in danger of false assumptions if they assume the

faith being expressed is in God or in religion. Some victims may be expressing

their faith in family, in rescuers, in relationships, in institutions, in their own

strength and stamina, or in natural law. Some will express faith in a combination

of these. Clarification is always helpful for effective spiritual care.

Dr. Kenneth Pargament from Bowling Green University researched

religious coping mechanisms used by people in trauma.69 The following

summary is based on his research. In times of distress, people may use their religion or spirituality in the following ways to answer the difficult questions surrounding critical events—disasters.

Benevolent religious appraisal

Seeks God’s loving presence

Spiritual leaders’ or affiliated members’ presence

Pleas for direct intercession

Acts of purification

Religious helping

Conversion

Blaming God or spirits

Religion and spirituality help people cope

Do not assume that “faith” is necessarily in God or religion

Coping mechanisms used by people in trauma


Demonic assignment

Punishment from God

Religious avoidance/distraction

Problem solving/deferral

Problem solving/self-direction

Problem solving/collaborative

Chaplains in disasters can facilitate spiritual care by affirming the positive

coping mechanisms being initiated by the victims. Multiple mechanisms may be

engaged simultaneously or spontaneously rejected.

Chaplains affirm positive coping mechanisms and gently adjust when

people suggest unhealthy means of coping with trauma and critical events. When

people suggest suicide, homicide, illegal activities, or behaviors that obviously

result in personal harm or a threat to others, the chaplain engages other

caregivers who are appropriately trained to handle such behaviors. For example,

a person who is suicidal needs immediate suicide intervention and professional

counseling. One of the ministry tasks of chaplains is that of shepherding—to be a

spiritual caregiver. Spiritual intervention and care means leading people beside

still waters and greener pastures—to a spiritually healthier and safer place.

Disaster chaplains recognize the wisdom of referrals to people who are more

highly trained to deal with special needs.

Chaplains are shepherds who help people cope during crisis

Spiritual Interventions for Disasters

George Everly, co-founder of the International Critical Incident Stress

Foundation, teaches that spiritual care interventions are additional interventions that are provided on the foundation of traditional crisis intervention mechanisms.

The traditional mechanisms include:70

Early intervention—Within hours of the traumatic event

Cathartic ventilation—ventilation of emotions

Social support—group model

Problem-solving—alternative solutions and responses

Cognitive reinterpretation—reinterpretation of event as non-threatening,

less challenging

In addition to the ministry of presence, the ministry of compassion, and the

ministry of caring through the art of story-listening, spiritual care agents in

disasters may choose to provide support through other spiritual care crisis

intervention methods that are uniquely theirs as people of faith and spirituality.71

Such methods include:

Scriptural education, insight, reinterpretation

Individual and conjoint prayer

Belief in intercessory prayer

Unifying and explanatory worldviews


Faith-based social support systems

Traditional mechanisms of crisis intervention . . .

Spiritual care crisis interventions . . .


Rituals and sacraments

Belief in divine intervention/forgiveness

Belief in a life after death

Unique ethos of the crisis interventionist

Uniquely confidential/privileged communications

Christian chaplains often have opportunities to share the Good News. When

victims ask the chaplain for other possibilities or for their personal beliefs, it is

entirely appropriate to share one’s personal faith. Sensitivity and respect in

asking permission to share—and not coercing victims—is a skill and approach

Jesus frequently used.

“Red Flags” for Disaster Chaplain Interventions

There is a sense of urgency that one experiences in the field of disasters. Disaster chaplains desire peace and spiritual strength for victims they encounter.

But the prudent caregiver is sensitive and aware of possible “red flags.” When

“red flags” are ignored, they become serious blunders that have long-lasting

consequences for the victims. Here are some “red flags:”

Trying to “wing it” with no specific intervention plans

Trying to provide interventions without a crisis team

Trying to debate theological issues with traumatized victims or survivors

Answering “Why?” questions without necessary precautions (see Unit 4)

Failure to honor the right to free exercise of religion

Failure to recognize severe or urgent stress symptoms

Failure to differentiate between ongoing clinical symptoms existing for a

person prior to the disaster and trauma symptoms resulting from the disaster

event

Red Flags

Ethics of Disaster Chaplaincy Interventions in Disasters

Disaster chaplains have a great responsibility entrusted to them. Integrity of

character is an expectation and betrayal is damaging to the entire profession.

High moral and ethical standards are expected and the crisis situation makes both

victim and caregiver vulnerable to ethical mistakes.

There are three areas of particular importance. The first is trust. Victims

have been reduced to the most basic levels of human development—that of trust.

When trauma happens, victims and survivors are shaken. They are fearful and

distrustful of the situation. Disaster chaplains are often perceived as God

figures—parents, protectors, providers, healers. Chaplains tread on thin ice

when they attempt to play God.

Chaplain conversations are uniquely confidential. If you must reveal any

part of a conversation, you must have the permission of the confidant. If a

person demonstrates clear and imminent danger to themselves (suicide threat) or

others (homicidal threat or actual threat of other serious crimes), the chaplain is

Victims and chaplains are vulnerable

Guard what has been entrusted to you

Maintain confidentiality


required to act in the best interests of the individuals and/or the persons(s) who

may be in danger. Saving a life has the highest priority.

Maintain confidentiality, tell the truth, do not make value judgments, and do

not take sides. Ego makes caregivers vulnerable.

Victims may be quite vulnerable during traumatic events—especially to

spiritual conversions or changes. Spiritual care agents should not use

manipulative rhetorical devices or forceful tactics to entice victims into making

choices they may later regret or ignore. Providing a good spiritual diagnosis of

the situation will help the chaplain avoid coercing victims and lead him or her

toward recommending meaningful spiritual responses in the disaster context. A

good diagnosis of the spiritual situation will depend on how well the chaplain

employs his or her listening skills with victims and to the Spirit of God.

Spiritual care in disasters involves meeting people in their desperate

circumstances, understanding the level of their needs, and then helping them

discover the best way to initially engage their own spiritual resources and other

available resources in order to overcome the challenges related to a crisis event.

Preaching and organized teaching are usually reserved for more formal settings

in the aftermath of a disaster such as funerals, memorial settings, or worship

services immediately following the event. Crisis Management Briefings

(CMB’s) are also excellent settings to provide significant information and

organized teaching on key insights concerning disaster responses.

The spiritual caregiver’s primary role is to assist victims in determining their

physical condition and exploring their thoughts or feelings in a manner that helps

them formulate spiritual insights and responses that will reflect the affected

person’s desired state of spiritual stability. Disaster relief chaplains should also

be prepared to provide information about local churches or other available

resources for assisting persons with concerns about their spiritual stability.

Connecting survivors to local churches can provide them with follow up avenues

that will be available long after the chaplain has left the affected area.

Chaplains are also expected to maintain their own standards of ethical

responsibility. There are many religious rituals and practices that may be in

conflict with your own beliefs and practices. Prior to providing crisis

interventions, chaplains should inform their team members and colleagues about

any possible interventions they may not be able to provide. When possible, they

should find other appropriate spiritual caregivers.

Ego makes caregivers vulnerable

Respect victim vulnerability

Guard personal standards

What Victims Want to Say to Disaster Chaplains

After many hours on the field of disasters and after many conversations,

disaster chaplains have learned many lessons from victims and survivors. Most

of the time, victims will not say these things to the chaplain—they just close

down, retreating into their pain and grief, swallowed by the confusion and shock.

Rev. Dr. Richard P. Lord expressed many of these feelings in a paper entitled

“Out of the Depths: Help for Clergy in Ministering to Crime Victims.”


Do not explain—even when I cry out “Why?” I am not looking for rational,

logical answers, but I want God and you to be with me in my pain.

Do not try to take away my pain—the pain shows me how much I have lost.

It might be uncomfortable for you, but please respect my reality. I will not

always be like this.

Stay close to me—I need someone to lean on right now. I may withdraw for

awhile, weep, grieve, mourn, or want to talk. Stay close so I can reach out to

you.

Remember me when everyone else has gone back to their normal routines—

be the person who will listen to my story and pain again and again. Mention

my loved one by name and remember with me.

Listen to my doubts—I have doubts and I need you to listen to my doubts.

Do not try to talk me out of it, but be with me as I move through it so a more

meaningful faith can emerge.

Do not be afraid of my anger—I need to be honest about the pain I feel. I

will not hurt myself or others and God is not threatened by my anger. Anger

is not nice to be around, but I need to work through this.

Be patient with me—my progress may not be as fast as you think it should

be. Let me reveal my weaknesses and regression to you sometimes. I will

get better in time.

Remind me that this is not all there is to life—I need to be reminded that

there is more to life than the pain and anger and sadness I am feeling. Speak

about God to me as an affirmation of life. I need Him to be a companion on

this painful journey. Remind me that His eternal presence can penetrate my

grief.

What would you have liked to have said to the person who ministered to you?

Victims want to say . . .

What would you have liked to have said to the person who ministered to you?

Conclusion

Providing spiritual care in disasters is a difficult task. There are few

quantitative ways to measure its effectiveness and there are few, if any, visible

results while on the field. Disaster chaplains seldom see the victims after the

initial contact, and most of the time, words and actions are completely

inadequate. We must remember that the ministry is in the willingness to enter

the place of pain and hurt and offer our presence and compassion.


MINISTERING IN THE MIDST OF DIVERSITY72

UNIT 10

The experience of trauma is the disaster relief chaplain’s primary context,

but he or she will also encounter the added context of cultural diversity. If the

chaplain is to offer the greatest amount of care and to be the most effective, he

or she should also be sensitive to the diversity of backgrounds, world views,

customs, religions, and so forth present in the affected community.

Contextualized Ministry Is Cross-Culturally Competent

Intentional Cultural Diversity Creates Multiple Needs

Culture is “the totality of socially transmitted behavior patterns, arts, beliefs, institutions, and all other products of human work and thought characteristic of a

community or population.”73 Greater than national identity or ethnicity, it

includes communities of vocation, education, location, or motivation; and it provides social support in safety and security, cushioning people from the impact

of traumatic events.74

Globalization and the age of technology have created new cultural norms.

Identification by dual identities is not uncommon—Japanese American, Spanish-

speaking Native American, moderate Baptist, conservative Republican. These

multiple cultural sources may decrease the ability to develop a sense of safety

and security, but they may also provide alternative interpretations to cope with

traumatic events. Cultural references and identity influence the identification

and interpretation of traumatic threats and events, affecting the manifestation of

traumatic response.75

“Corporate America’s decision to emphasize diversity is a practical choice,

based on rapidly evolving U.S. demographics. Recognizing economic

opportunity, corporate leaders are spearheading machines for multicultural

workforces and emerging-market strategies.”76 The intentional emphasis on

creating cultural diversity inevitably multiplies needs in crisis. Crisis

interventions must be concerned with issues related to birth, death, spirituality,

possessions, power, children, elderly, income, education, nationality, sexual

orientation, and profession, and with how they are influenced by various cultural

identities. Intentionally recognizing cultural diversity creates multiple needs and

new paradigms for “normal” or “expected” crisis needs.

Cultural Perspectives Affect Trauma and Recovery

“Culture influences what type of event is perceived as threatening or as

traumatic.”77 In third world countries, the death of a child may be perceived as a

predictable event, while in the U.S., it may be defined as traumatic.78 In a study conducted by Carlson and Rosser-Hagan (1994), Cambodian refugees who had been assaulted (50%) or experienced the killing of a family member (60%) rated

food shortage more distressing than the death of a close relative.79 Most Americans can not relate to feeling distressed over food shortage.

Culture is what identifies a group—physically, socially, relationally, intellectually, emotionally, behaviorally, and spiritually

Multiple cultural identities help and hinder coping mechanisms in trauma

Cultural diversity multiplies needs in crisis

Culture interprets events as threatening or traumatic


Culture influences how people interpret the meaning of their traumatic

event (fate, punishment, reward). It also influences how people express their

reactions to traumatic events (withdrawal, silence, hysteria, physical abuse,

stoicism, embarrassment). And finally, “cultures can help to define healthy

pathways to new lives after trauma. The routines and traditions of the culture

may aid survivors of a tragedy in feeling reoriented. This is particularly true

when . . . cultures have a means of integrating an individual’s trauma story with

the theology, spiritual orientation, or mythology of the culture.”80 An important

aspect of crisis intervention is allowing victims to create a narrative of their crisis

experience. By doing so, the event becomes a part of a life story rather than an

event which culminates a life story.

Demonstrating Respect for Cultural Differences

The modern world is characterized by a high level of cultural diversity.

Ethnic heritage, language, political affiliation, and religion are often the product

of intersecting cultures. Vocation, recreation, and social economic levels have

become cultural categorizations. Music, sexual orientation, and sports have also

become cultural identifications. Respect for cultural differences may be

demonstrated in the following ways:

1. The chaplain demonstrates respect for cultural differences by

acknowledging these differences without judgment.

2. Chaplains must also accommodate cultural differences.81 Through

education, chaplains gain an understanding of cultural perspectives.

“Prior to cross-cultural work, education is needed on differences about a

culture’s background history, language, routines, traditions, and family

structures. This knowledge should be used to inform the crisis

responders in the use of more appropriate interventions.”82 Through

networking and building relationships, chaplains also gain access to

different cultures, enabling them to apply their understanding of cultural

behaviors, metaphors, concepts, and ethics.

3. Demonstrating respect for cultural traditions and values during some of

the greatest moments of suffering and loss is a clear demonstration of

cultural sensitivity. In disaster relief ministry, knowledge of ethnic

variations in death, dying, and grief is particularly important. Crisis and

disasters often result in death.

4. Chaplains must demonstrate cultural competence.83 They must be able

to integrate their knowledge, sensitivity, and awareness of cultural

differences into their crisis response, thereby mitigating stress, providing

comfort, and promoting healing. Their behaviors, attitudes, and policies

must be congruently directed towards effectively operating in a different

cultural context. Chaplains demonstrate respect for cultural differences

by demonstrating cultural competence—familiarization with significant

cultural characteristics, acknowledging the differences, developing

sensitivity and understanding of other ethnic groups, and integrating this

information into their caring responses.

Culture influences the effects of traumatic events

The world is characterized by a high level of cultural diversity

Chaplains demonstrate respect for cultural differences by demonstrating cultural competence


Maintaining Personal Faith

The nature of disaster relief ministry is significantly different than ministry

in the local church. Participants of a local church choose to gather under the

ministrations of a particular person because of “. . . agreement with or

appreciation for the ecclesiastical, doctrinal, theological . . . issues of importance.

In general, the members within a congregation share commonality in faith

issues.”84 In a local church, members and other affiliates have a single faith-

group focus. In disaster relief, victims do not choose their displacement, loss, or

chaplain—their choices are limited. A chaplain in disasters has a multiple faith-

group focus, ministering in a pluralistic environment, demonstrating respect and

understanding of other spiritual experiences without compromising his or her

faith. While attempting to acknowledge and accommodate differences, the

chaplain may find that his or her personal faith conflicts with the victim’s faith or

values. Ministry in diversity may pose issues of concern, but it is not a call to

abandon or violate one’s personal faith and values. Referrals are not the only

solution, and reconciliation is possible.

“Red Flags” for Chaplains in a Context of Diversity

Chaplains must recognize some “red flags” when serving as disaster relief

interventionists in the context of cultural and religious diversity. Because

victims are highly vulnerable, chaplains must be careful not to coerce victims in

any way. Forcing victims to talk, to eat, or to make life changing decisions may

be perceived as unethical. Victims are usually concerned about the most

fundamental human needs—safety and security—and may have little or no

ability to make rational or logical decisions about faith and religion. But

chaplains have an opportunity to appropriately and gently lead victims toward

healthier spiritual lives. Without coercion (trying to force people to become

Baptists), chaplains could share the love of Christ and allow the Holy Spirit to do

His work. Chaplains must also beware of projecting attitudes of superiority (i.e.,

“I’ve responded to many disasters and seen lots of victims, so I know exactly

what you’re going through, what you’re feeling, and what you need.”), uninvited

familiarity (e.g., addressing victims as “honey,” “dear,” or “good buddy”), false

imitation (e.g., attempting to more closely identify with African American

victims by affecting speech patterns that are not “natural” to the non-African

American chaplain), and false assumptions (e.g., life without one’s home and

possessions is better than not dying, a Muslim victim will reject ministry from a

Baptist chaplain, or a request for a “miracle” arises from a Christian value

system).

“Relief” for the Chaplain in the Context of Cultural and Religious Diversity

There is natural anxiety associated with providing spiritual care in the

context of cultural and religious diversity. Chaplains may be concerned about

whether or not they will be accepted or whether or not they will want to provide

intervention in some situations. These are natural concerns and most care

providers must address these issues before arriving on the field of service. Some

issues to be considered are:

Ministry in diversity is not a call to abandon or violate one’s personal faith

Red flags I must be especially aware of . . .

Give yourself some “grace” as you deal with sensitive personal issues


Redefining one’s ministry as a spiritual care provider in diversity

Respecting cultural and religious differences without compromising

one’s personal beliefs

Providing the freedom to the victim or client to choose or decline

ministry

Avoiding false assumptions regarding perceived needs

Knowing and understanding the priorities of one’s own faith when

ministering to diversity of religious traditions

Accepting “being” as appropriate ministry when “doing” something is

impossible.85

Principles for Ministering in Diversity

Culture is more than national identity or racial origin and is influenced by

many elements: ethnicity, age, gender, family of origin, nuclear family, marital

status, education, language, occupation, art, music, economic status, social status,

physical characteristics, handicaps or special needs, religion and spiritual beliefs,

geography, climate, environment, perceptions of time and space, dress, food,

recreation, and play. While there are many influences that create identity, most

victims will be rightfully or wrongfully “classified” by some uniquely

identifying characteristics. These are usually based on observable ethnicity,

language, gender, and age. However, for the chaplain in disasters, there are

many other issues that could be considered. It is helpful to be aware of some

general principles that apply in diversity.

There is wide diversity within some ethnic and national entities (e.g., not

all Anglos are Christian and not all South Americans speak Spanish).

Generalizations for all who fall within popularly used categories cannot

be made (e.g., not all Asians are short nor are all accountants “geeks”).

Most people are characterized by the intersection of multiple cultures

(e.g., a woman could be a mother, a business executive, an athlete, an

artist, a Jew, and a cancer survivor).

The multiplicity of cultural sources may decrease the ability to develop a

sense of safety and security (e.g., after 9/11, an Iranian Muslim airplane

pilot endured many hostile looks from passengers when he stepped into

the cockpit of an American plane).

Exposure to numerous cultural influences and worldviews (during

childhood, adolescence, and/or adulthood) may increase the capacity of

individuals to respond to serious traumatic events by providing them

with a broader, more multi-faceted understanding of an event(s), thus

providing awareness of alternative coping strategies.

Crisis interveners must quickly consider the sources of cultural identity

for victims.

The intensity of traumatic events vary according to the individual’s

ability to integrate such events into his or her experience (e.g., “I’ve been

through many hurricanes so I know I can get through this one.”).

Culture influences the perception of threat or trauma (e.g., CNN

reporters realize that being on the scene does not necessarily mean it’s

safe).

Some general principles . . .


Culture influences the expressions of traumatic reactions (e.g., some

people “keep a stiff upper lip” and others weep and wail hysterically).

Culture may condemn or exalt the response of victims (e.g., many Asian

cultures expect people to be stoic in the midst of crisis).

Culture can provide healing after trauma (e.g., appropriating Christian

forgiveness allows the perpetrator of the accident to move on with life

even when he or she caused the loss of a life).

Multiple cultural identities complicate trauma.

Cultural metaphors provide insights for interventions.

Language interpreters must also be able to interpret cultural responses

and interventions.

Education is essential in effective ministry in cultural diversity.

Culturally focused education must be accomplished for the specific

cultural identities in the chaplain’s circle of responsibility.

Chaplains Must Recognize the “UNKNOWN GOD” in Diversity86

Paul’s ministry demonstrates that one can be true to the command of the

Great Commission even while being sensitive to the pluralistic qualities of a

listener’s or groups’ cultural setting. At Athens, as recorded in Acts 17:16-34,

Paul used one approach with the Jews, often going to the synagogue, and a quite

different approach with the Gentiles—approaching them in the market. The

chaplain must be able to exercise such spiritual astuteness in diverse settings and

be bold in approaching people wherever they are accessible. This boldness may

involve providing ministry at a shelter, at a food distribution center, in the

parking lot where people gather to receive information about their disaster

dilemma, at a memorial service, or even before community leaders who may

disagree with your theological precepts.

Paul depicts that a tremendous compassion, concern, and respect for those

who hear the good news about the “UNKOWN GOD” is vital for sharing the

Gospel with persons from another culture. He exemplifies that a chaplain can be

culturally sensitive and still remain true to one’s own beliefs. Be aware that in

seeking this balance, Paul often found himself in life-threatening situations

throughout his ministry.

Paul’s ministry style also shows the importance of how timing and pace can

impact ministry. In Acts 27, the record of his shipwreck on the way to Rome

represents how initiative, godly counsel, and compassion can play a significant

role in crisis response. Paul led his traveling companions to trust him and

eventually follow spiritual guidance acquired from an “unknown God” in order

to preserve their lives. Chaplains must also cultivate the capacity to take such

initiative, develop trust, and yet maintain a humble spirit. In doing so, one must

search for the right time to express spiritual insights and be willing to submit to

proper authority, even when they respond in a manner that contradicts your

understanding. Though the chaplain is a representative and ambassador for God,

he or she is not and will never be God. As such, spiritual care agents cannot

decide for anyone how to think, believe, or act—even Jesus did not force others

to follow him.


Closely following the above mentioned qualities are the needs for a chaplain

to have a good understanding of the identified audience, a significant

understanding of one’s own faith and beliefs, patience to wait for the right time

to speak, and the ability to draw analogies from various cultures to illustrate

one’s religious convictions. These are just a few of the prominent qualities that

need development in responding to crisis situations. Above all, the chaplain

must demonstrate compassion for all persons and be prepared to engage first in

tangible ministry action in order to sometimes gain a better hearing of the

Gospel.

Clarifying Cultural Needs

Many reactions to crisis events and death are cross culturally similar.

However, chaplains may experience some anxiety as they approach victims

whose cultural identity is unfamiliar or different. With a desire to help, not

harm, chaplains hesitantly enter the relationship. Clarification is an important

aspect of diagnosis and preparation. Helping survivors and families deal with

traumatic death is based on respect and care.

Clarification questions could be very helpful after initial contact is made.

Some questions might include:

Is there anything special you’d like me to know about how to help you

through this crisis?

What would be the most helpful thing I could do for you right now?

Is there anything special I could do for (deceased)?

Is there anything special I could tell someone about how you would like

’s body handled?

Do you have any special religious needs I could help you with?

Do you have any questions about what will be happening now?

Do you have any religious or cultural restrictions I should be aware of?

Summary

“Cultures vary in their attitude toward time, toward property, how they

share resources, how family and community are defined, in division of labor

between the sexes, in how they teach their children, how they play, and in many

other ways.”87 To minister effectively to victims of disasters and emergencies,

chaplains must contextualize ministry responses to respect cultural heritage,

traditions, and values through an understanding of how culture affects trauma

and recovery, by acknowledging and accommodating differences, and by

maintaining their personal faith while ministering in the midst of cultural and

religious diversity. Chaplains must facilitate the practice of personal faith

expressions for victims of many cultural entities while guarding their own

personal beliefs and values. The chaplain who values his or her own personal

faith is the one who is able to appreciate the faith of others.

Disaster chaplains could ask clarifying questions

Chaplains in disasters must contextualize ministry

Common Religious and Cultural Customs Concerning Death88

African American Mexican American Native American Asian American Anglo American High involvement of

funeral director

Friends and family gather at home

Wake

Worship service – “Home Going”

Shared meal after wake and funeral

Funeral service and burial

Cremation less accepted

Deep religious faith and integration of church observances

Memorial service

Commemorative gifts

Grief expression very emotional

High involvement of the priest in funeral plans

Family and friends encouraged to be a part of the commemoration

Rosary said by survivors at the home

Some say rosary each night for 9 nights

Some say rosary every month for a year

Some say rosary on each anniversary

Catholic funerals include a Mass

Many commemorate the loss with promises or commitments – taken very seriously and failure to honor them is considered a sin

Money gifts to help pay for funeral and burial typical

Medicine man, shaman, or spiritual leader moderates the funeral

Some burials are non traditional – some resistance to laws of burial or cremation

Call on ancestors to help deceased in transition

Embalming not common

Dismemberment and mutilation outside natural deterioration is taboo

Sentimental things and gifts are buried with the body

Burial must be in native homeland or reservation

Pipes are smoked at gravesite

Some significance with symbolic reference to circle

Some significance in non- burial for natural passage

Family elders assume responsibility for funeral

Great respect for the body

Warm clothes for burial

Watertight caskets

Stoic attitudes

Grief internalized – often results in depression

Open casket

Poems in calligraphy left for deceased

Cooked chicken placed by casket and buried with body (Chinese)

Music used

Band accompanies casket to cemetery

Funeral route very important

Location of burial plot important

Monument important

Some groups, sacrifices at gravesite

Meal and gathering of family and friends after funeral

Picture or plaque displayed in home as shrine

Commemoration at 49 days

Ceremony twice a year at grave or home shrine

Blue is color of mourning

Nuclear family plans funeral with minister

Family and friends gather at home

Wake or Viewing

Usually open casket

Funeral or memorial service to commemorate the life of the deceased

Services include music and eulogies or testimonials

Cremation is acceptable

Black is appropriate dress

Flowers and donations are acceptable to honor

Confession, communion, prayers prior (RC)*

Wake and Rosary (RC)

Mass (RC)

Anniversaries celebrated with Mass

Autopsies and embalming generally prohibited (J)**

No viewing of corpse (J)

No funeral on Sabbath or major religious holidays (J)

Music and flowers not encouraged (J)

Eulogies by rabbis, family, friends (J)

Family members put shovel of dirt on casket (J)

Mourning for one year (J)

Sitting shiva – 7 day mourning for family(J)

No visitors for 3 days (J)

Torn garment or ribbon for a week (J)

First anniversary marked by unveiling of tombstone at special ceremony (J)

Fig. 5. Naomi Paget, “Anglo American,” Marketplace Samaritans, Inc., 2002.

*Roman Catholic **Jewish



WHAT TO DO NEXT

UNIT 11

Pre-training requirements for approval as a Southern Baptist Disaster

Relief Chaplain: 1. Read the Disaster Relief Chaplain Training Manual

https://www.namb.net/resources/southern-baptist-disaster-

relief-chaplain-manual

2. Register for a Disaster Relief Chaplain Training Manual course

Date Completed

Training requirements for approval as a Southern Baptist Disaster

Relief Chaplain : 1. Complete Introducing Southern Baptists to Disaster Relief

(provided by your state disaster relief director)

2. Complete the Disaster Relief Chaplain Training Manual course a. Check with your state disaster relief director or state

disaster relief chaplain leader

b. Check with the national coordinator for disaster relief

chaplaincy

3. Complete one of the following options:

a. A Critical Incident Stress Management (CISM) course

i. Recommended: “Assisting Individuals in Crisis” or

“Spiritual & Psychological First Aid” or “Group

Crisis Intervention”

ii. Most CISM courses are 13-14 hours

b. Operational Stress First Aid (OSFA)

i. The six hour OSFA course 4. Read the National Voluntary Organizations Active in Disasters

(National VOAD) Disaster Spiritual Care Points of Consensus

and Disaster Spiritual Care Guidelines

(https://www.nvoad.org/resource-center/member-

resources/?mdocs-cat=mdocs-cat-62&att=null)

http://www.namb.net/resources/southern-baptist-disaster-

http://www.namb.net/resources/southern-baptist-disaster-

http://www.nvoad.org/resource-center/member-

http://www.nvoad.org/resource-center/member-


Recommendations for Training & Education in Disaster Relief Chaplaincy

Training in Crisis Intervention and Stress Management

Operational Stress First Aid (OSFA) (7 hour version)

Critical Incident Stress Management: “Assisting Individuals in Crisis” (13hours)

Critical Incident Stress Management: “Group Crisis Intervention” (14 hours)

Critical Incident Stress Management: “Spiritual & Psychological First Aid” (14 hours)

Critical Incident Stress Management: “Grief Following Trauma” (14 hours)

Critical Incident Stress Management: “Emotional & Spiritual Care in Disasters” (14 hours)

Critical Incident Stress Management: “Suicide: Prevention, Intervention & Postvention”

Critical Incident Stress Management: “Stress Management for the Trauma Provider” (14 hours)

Critical Incident Stress Management: “Managing School Crisis” (14 hours)

Critical Incident Stress Management: “Workplace Violence” (14 hours)

Critical Incident Stress Management: “Law Enforcement Perspectives” (14 hours)

Training in Disaster Chaplaincy

Red Cross Disaster Spiritual Care Fundamentals

Red Cross Psychological First Aid

Red Cross Disaster Cycle Services

Training Topics for Chaplaincy and Interpersonal Relationships

Disaster Relief Chaplaincy

Emerging Trends in Disaster Spiritual Care

Spiritual Resilience

Stress Management

Conflict Resolution

Forgiveness

These are also helpful, but have pre-requisites (see www.ICISF.org)

Critical Incident Stress Management: “Advanced Group Crisis Intervention” (14 hours)

Critical Incident Stress Management: “Advanced Assisting Individuals in Crisis” (14 hours)

Critical Incident Stress Management: “Strategic Response to Crisis” (14 hours)

Mandatory Reading

Read and abide by the following National Voluntary Organizations Active in Disaster (NVOAD),

Emotional and Spiritual Care resource documents:

a. “Light Our Way”(online at www.nvoad.org or www.crisisplumbline.com)

b. Points of Consensus (online at www.novoad.org or www.crisisplumbline.com)

c. Disaster Spiritual Care Guidelines (online at www.nvoad.org or www.crisisplumbline.com)

Recommended Reading

Billy Graham Evangelistic Association (BGEA) “His Presence in Crisis” Rapid Response training curriculum

Cisney, Jennifer S. and Kevin L. Ellers. The first 48 Hours: Spiritual Caregivers as First Responders.

Nashville: Abingdon Press, 2009.

Floyd, Scott. Crisis Counseling: A Guide For Pastors and Professionals. Grand Rapids, MI: Kregel

Publications 2008.

NYDIS Manual for New York City Religious Leaders: Spiritual Care and Mental Health for Disaster

Response and Recovery (see also “NYDIS Tip Sheets”) (available online)

Paget, Naomi K. and Janet R. McCormack. The Work of the Chaplain. Valley Forge: Judson Press, 2006.

Roberts, Stephen B. and Willard W.D. Ashley, Sr., eds. Disaster Spiritual Care: Practical Clergy

Responses to Community, Regional and National Tragedy. Woodstock, VT: Skylight Paths

Publishing, 2008.

The Salvation Army (TSA) “Emotional and Spiritual Care in Disasters Training Guide

Wright, H. Norman, The New Guide to Crisis and Trauma Counseling, A Practical Guide for Ministers, Counselors and Lay Counselors, Ventura: Regal Books, 2003.

http://www.icisf.org/

http://www.nvoad.org/

http://www.novoad.org/

http://www.nvoad.org/


RESOURCES FOR DISASTER RELIEF CHAPLAINS

UNIT 12

Agencies

North American Mission Board

Adult Volunteer Mobilization/Disaster Relief

4200 North Point Pkwy.

Alpharetta, GA 30022

(770) 410-6000

www.namb.net

American Red Cross

American Red Cross National Headquarters

Disaster Services

2025 E St., NW

Washington, DC 20006

Phone: (202) 303-4498

FAX: (202) 303-0241

www.redcross.org

Salvation Army

Disaster Services

440 West Nyack Rd.

West Nyack, NY 10994-1739

Phone: (845) 620-7200

FAX: (845) 620-7766

www.salvationarmy-usaeast.org

International Critical Incident Stress Foundation

10176 Baltimore National Pike, Ste. 201 Ellicott City, MD 21042-3652

Phone: (410) 750-9600

FAX: (410) 750-9601

www.icisf.org

http://www.namb.net/

http://www.redcross.org/

http://www.salvationarmy-usaeast.org/



Professional Organizations

Association of Professional Chaplains

1701 E. Woodfield Rd., Ste. 311 Schaumburg, IL 60173

Phone: (847) 240-1014

FAX: (847) 240-1015

www.professionalchaplains.org

National Association of Catholic Chaplains

P.O. Box 070473

Milwaukee, WI 53207-0473

Phone: (414) 483-4898

FAX: (414) 483-6712

www.nacc.org

National Association of Jewish Chaplains

901 Route 10 Whippany, NJ 07981-1156

Phone/FAX: (973) 736-9193

www.najc.org

Association for Clinical Pastoral Education, Inc.

1549 Clairmont Rd., Ste. 103 Decatur, GA 30033-4635

Phone: (404) 320-1472

FAX: (404) 320-0849

www.acpe.edu

American Association of Pastoral Counselors

9504-A Lee Hwy.

Fairfax, VA 22031-2303

Phone: (703) 385-6967

FAX: (703) 352-7725

www.aapc.org

American Association of Christian Counselors

P.O. Box 739

Forest, VA 24551

1 800 526-8673

www.AACC.net

http://www.professionalchaplains.org/

http://www.nacc.org/

http://www.najc.org/

http://www.acpe.edu/

http://www.aapc.org/

http://www.aacc.net/


Community

Churches

Associations

Hospitals

Counseling Centers

Shelters

Funeral Homes

Food Banks

Clothing Closets

Literature and Music

Prayers

Memorial Services

Funeral Services

Dedications

Other Rites and Rituals

Contacts

Community Churches

Community Faith Group Houses of Worship

Community Clergy

Community Clergy Associations

Law Enforcement

Victim Advocates or Victim Assistants

Community Support Groups

Community Emergency Preparedness Agencies

Department of Social Services

Local Red Cross


ENDNOTES

1Naomi Kohatsu Paget, “Disaster Relief Chaplaincy for Community Clergy” (D. Min. diss., Golden Gate

Baptist Theological Seminary, 2003), 1-3.

2ARC, “Ripple Effect”, 2001.

3Paget, “Disaster Relief Chaplaincy for Community Clergy,” 12-21.

4W. E. Vine, “Compassion,” in Vine’s Expository Dictionary of New Testament Words (McLean: MacDonald

Publishing Company, n.d.), 220.

5 Webster’s Encyclopedic Unabridged Dictionary of the English Language, 1st ed. (1989), s.v. “compassion.”

6Henri J Nouwen, Donald P. McNeill, and Douglas A. Morrison. Compassion (New York: Doubleday,

1982), 4.

7The primary didactic and clinical training and preparation a chaplain has is through CPE. One of the primary

objectives is to teach the chaplain the differences between chaplaincy, social work, parish pastorates, and mental

health. The chaplain is taught the significance of “being” as an ontological expression in contrast to “doing”

(Thomas V. Sullivan, in the general orientation of CPE students, [Worcester, MA: St. Vincent Hospital, 1994]).

8All Scripture quoted is from The Holy Bible, New International Version unless otherwise noted.

9Thomas C. Ogden, Classical Pastoral Care, vol. 4, Crisis Ministries (Grand Rapids: Baker Books,

1994), 3.

10Henry Blackaby, Experiencing God Day-by-Day (Nashville: Broadman & Holman Publishers,

1997), 213.

11Henri J. Nouwen, The Wounded Healer (New York: Doubleday, 1979), 81-82.

12Brother Lawrence wrote several letters that explained how he practiced the presence of God. Key to this was

praying throughout each day to attain spiritual fulfillment (Brother Lawrence, The Practice of the Presence of God

[New Kensington: Whitaker House, 1982], 8, 29).

13Becker writes that a Zulu visitor may sit at the gate for hours—just being present—before beginning the

relationship rebuilding that precedes the point of the visit. (Arthur Becker, The Compassionate Visitor [Minneapolis:

Augsburg Publishing House, 1985], 35).

14The tension between the relevance of Christ and the culture in which one lives is an “enduring problem.” H.

Richard Niebuhr, Christ and Culture (New York: Harper & Row, 1975), 42.

15 “Nowhere has the effect of globalization been felt more radically than in the church. . .” Leith Anderson,

Dying for Change (Minneapolis: Bethany House, 1990), 22-23).

16Today, the closest counterpart for lepers may be AIDS victims (Craig L. Blomberg, Matthew, The New

American Commentary, vol. 22 (Nashville: Broadman Press, 1992) 138.

17Webster’s Encyclopedic Unabridged Dictionary of the English Language, 1st ed. (1989), s.v. “help.”

18Robert K. Greenleaf, Servant Leadership: A Journey into the Nature of Legitimate Power and Greatness

(New York: Paulist Press, 1977), 13-14.


19Southern Baptist Convention, North American Mission Board, Involving Southern Baptists in Disaster Relief

(Alpharetta, GA: NAMB, n.d.) 29.

20Roberta C. Bondi, To Pray and to Love (Minneapolis: Fortress Press, 1991), 132.


22Timothy George, Galatians, The New American Commentary, vol. 30 (Nashville: Broadman & Holman,

1994), 413.

23Ibid., 413-415.

24Naomi K. Paget, in Disaster Relief Chaplaincy Training Part I, Denver Baptist Association, June 5, 2003,

Denver, CO.

25Francis Thompson, Poetical Works of Francis Thompson (New York: Oxford University Press, 1969), 89-94.


27Some other issues include how to bear witness to the Gospel without proselytizing, how to function under

chain-of-command, and when to excuse oneself from service.

28North American Mission Board, Involving Southern Baptists in Disaster Relief (Alpharetta: NAMB, 2000),

27-28.

29Naomi K. Paget, Pastoral Care During and After A Disaster: Psychosocial Training for Clergy (Newtown,

CT: Marketplace Samaritans, Inc., 2003), 12-18.

30It should be noted that while these are traditionally called “man-made disasters,” these disasters are caused by

both men and women and are not necessarily gender specific.

31Paget, Pastoral Care During and After A Disaster: Psychosocial Training for Clergy, 19-25.

32Ibid., 26.

33Erik H. Erikson, Identity and the Life Cycle (New York: W.W. Norton & Company, 1980), 53-107.


35Hans Selye, Stress Without Distress (New York: New American Library, 1974), 14.

36Richard A. Swenson, Restoring Margin to Overloaded Lives (Colorado Springs: Navpress, 1999), 29.

37 Jeffrey T. Mitchell and Grady P. Bray, Emergency Services Stress (Englewood Cliffs: Brady Prentice Hall

Career & Technology, 1990), 3.

38Mitchell and Bray define trauma as an event outside the usual realm of human experience that would be

markedly distressing to anyone who experienced it. Experiencing the event may be personal or vicarious, the

exposure to human suffering.

39Mitchell and Bray, 7-10.

40Eve B. Carlson, Trauma Assessments (New York: The Guilford Press, 1998), 40.

41Marlene Young, “Coordinating a Crisis Response Team,” The Community Crisis Response Team Training


Manual, 3d ed. (Washington, D.C.: National Organization for Victim Assistance, 2002), 2-6 – 2-13.


43Young, 7-2.

44Naomi K. Paget, “Spirituality in the Workplace” (Longmont, CO: Marketplace Samaritans, Inc., 2000).


46Henri J.M. Nouwen, The Way of the Heart (San Francisco: Harper San Francisco, 1981), 44.

47Howard Clinebell, Basic Types of Pastoral Care & Counseling (Nashville: Abingdon Press, 1984), 75.


49Some other issues include how to function under chain-of-command and when to excuse oneself from

service.

50The mission statement and purposes of the International Critical Incident Stress Foundation may be found at

their website, www.icisf.org.


52 Mitchell and Bray, 134.


54J. Ezhanikatt et al., “Compassion,” in Dictionary of Pastoral Care and Counseling, ed. Rodney J. Hunter

(Nashville: Abingdon Press, 1990), 207.

55Kenneth C. Haugk, Christian Caregiving: A Way of Life (Minneapolis: Augsburg Publishing House,

1984), 69.

56It should be noted that not all pastoral caregivers will or should respond to every disaster. Personal history

and experience may render the pastoral caregiver ineffective in a particular situation—the pastoral caregiver’s own

grief, caused by a similar disaster, may evoke memories too powerful to enable him or her to enter into another’s

suffering in a meaningful way.

57Dave Mullis, Military Chaplaincy Associate of the North American Mission Board, defines pluralism as “a

coalition of diverse ethnic, racial, religious, or social groups seeking to maintain autonomous participation in and

development of their traditional culture or special interest within the confines of a common society. . . . Religious

pluralism seeks an environment in which all faith expressions can dwell together. Religious pluralism is more than

tolerance for other faith groups. Religious pluralism would seek to create an understanding of the spiritual

experience reflected in other religious expression. The resulting understanding seeks peace and unity through

reduced fear, resistance and resentment of one another. Pluralism is not universalism. Religious pluralism creates

room for various faith practices without expecting compromise of a faith doctrine or tradition. This functional

diversity should be regarded as a strength rather than a weakness in chaplaincy ministry. . . . Pluralism means that

the chaplain exercises their [sic] own religious faith and ministers with understanding for the religious faith of

others” (Dave Mullis, “Business and Industrial Chaplaincy: the Chaplain’s Ministry Plan” [D.Min. diss., Regent

University, School of Divinity, 1999], 9-10).

58 Naomi K. Paget and Janet R. McCormack. The Work of the Chaplain (Valley Forge, PA: Judson Press,

2006), 117.



59Haugk, 71-73.

60 George S. Everly Jr., Pastoral Crisis Intervention (Ellicott City, MD: Chevron Press, 2007), 14.

61Young, 18-3 – 18-6.


63

Erich Lindemann affirmed Freud’s concept of “working through life’s problems” and affirmed grief as

“work.” He first suggested that there were discernable stages in the grief process that the grieving person must work

through. Kubler-Ross popularized the concept of stages of grief as she studied dying patients at the University of

Chicago Hospital (Lindemann had studied those who had lost someone close to them through death). Later, Granger

Westberg popularized Lindemann’s stages of grief as pastoral wisdom in his little book, Good Grief, published in

1962.


65Michael T. Mannion, “Making Sense of Victimization Through a Spiritual Vision,” in 2001: The Next

Generation in Victim Assistance (Dubuque, IA: Kendall/Hunt, 1994). Referenced in Young, 9-6 – 9-7.

66N. Duncan Sinclair, Horrific Traumata: A Pastoral Response to the Post-Traumatic Stress Disorder (New

York: Haworth Pastoral Press, 1993), 65.

67“Faith in Psychiatry,” Psychology Today, July/August 1995, citing to studies done by David Larson,

psychiatrist and resident of the National Institute for Health Care Research.

68Young, 9-9 – 9-12.

69Young, 9-29 – 9-34.

70Jeffrey T. Mitchell and George S. Everly, Jr. Critical Incident Stress Debriefing: An Operations Manual for

CISD, Defusing and Other Group Crisis Intervention Services, 3d ed. (Ellicott City: Chevron Publishing

Corporation, 2001) 59-66.

71Ibid., 236.


73The American Heritage Dictionary of the English Language, s.v. “culture.”

74

M.W. deVries, “Trauma in Cultural Perspective,” in Traumatic Stress, ed. B.A. van der Kolk, A.C.

McFarlane, and L. Weisaeth (New York: Guilford Press, 1996), 115.

75Young, 15-6—15-9.

76“The Business Case for Diversity, Part 1: Shifting Demographics,” DiversityInc.com,

www.diversityinc.com/public/1784.cfm; Internet; accessed 20 November 2001.

77Young, 15-47.

78The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; APA, 1994)

defines trauma exclusively in terms of the exposure to human suffering, i.e., personal or vicarious exposure to severe

injury, illness, or death. A trauma, therefore, may be seen as a more narrow form of critical incident (a crisis event

that causes a crisis response).

http://www.diversityinc.com/public/1784.cfm%3B


79C.M. Chemtrob, “Posttraumatic Stress Disorder, Trauma, and Culture,” International Review of Psychiatry 2, Chapter 11.

80Young, 15-56.

81Religious accommodation poses difficulties for many pastoral caregivers who struggle with the issue of how to maintain

personal faith integrity. This issue is addressed in the following subsection.

82Young, 15-64.

83The idea of improving cross-cultural ability is reflected in several terms—cross-cultural knowledge, cross- cultural

sensitivity, and cross-cultural awareness. These are defined in Unit 2.

84Solomon Kendagor, “Maintaining Personal Faith While Ministering in the Midst of Religious and Cultural Diversity,”

Association of Professional Chaplains conference, February 2002.

85Ibid.

86 Naomi K. Paget and Janet R. McCormack, The Work of the Chaplain (Valley Forge, PA: Judson Press, 2006), 10-11.

87 “Working Through Cultural Differences,” www.ethnicharvest.org/links/culture.htm; Internet; accessed 13 June 2002.

88Young, 15-134 – 15-140

http://www.ethnicharvest.org/links/culture.htm%3B


Phases of Disaster or Crisis

Honeymoon (Community Cohesion)

Long Term Rebuild

Predisaster

Recovery Heroic

Disillusionment

Profound Reactions to event

Reconstruction

A New

Inventory

Secondary Injuries

Struggle to Adapt Beginning

Reintegrate

Trigger Events

and Anniversary

Reactions

Possible Long Term reaction:

PTSD/Grief

Impact Recoil Reorganization

1 to 3 days Time Line 24 hrs. to 6 wks. 2 to 5 years can vary per victim

V. SPIRITUAL DISTRESS

• Anger at God

• Doubt

• Indebtedness

• Unnecessary guilt

• Lack of trust

• Selfishness

• Ungratefulness

• Judgmental/ legalistic

• Self condemnation

• Fanaticism

• Withdrawal from faith-

based community

• Over-simplistic cliché

theology

• Cessation of faith -

related practices

Threat/Warning

Emergency

A.1


Distinctives of DSC Chaplains and Community Clergy

DR Chaplain

• Volunteer

• Short term service

• Strangers

• Pluralistic settings

• Ministers in crisis and disaster settings

• Accountable to an agency or program of the faith tradition hierarchy

Community Clergy

• Professional status

• Long term service

• Established relationships

• Specific Religious counseling

• Ministers in houses of worship or home

• Accountable to congregation or faith tradition hierarchy

Distinctives of DSC Chaplains and DEC Mental Health

DR Chaplain Mental Health

• Endorsed by faith group - Licensed by the state or association

• Trained in pastoral care - Trained in psychopathology

and counseling

• Focus on faith and meaning - Focus on coping and stress

• Language of spirit and purpose - Language of feelings, behavior, and cognition

• May be licensed mental health - May be chaplain

A.2


Suddenness

History of grief & loss

Perception

Coping skills

Support system

Faith system

Culture

Multiple events

Age

Presence of the body

Witness to the traumatic event

Prolonged events

Nature of secondary losses

Relationship with the deceased

Spacing of events

Unrecognized or unacknowledged loss

Prior mental and physical health

Resistance & resilience factors

Grief Factors

Patterns of Grief

Instrumental Think, do, facts, organized, scheduled

Intuitive Feel, reminisce, emote, spontaneous

Blended

A.3

Kenneth Doka on Grief Counseling and Psychotherapy, 2010 http://www.psychotherapy.net/interview/grief-counseling-doka#section-intuitive-vs.- instrumental-grieving

http://www.psychotherapy.net/interview/grief-counseling-doka#section-intuitive-vs.-


Comparing Burnout, Empathy Fatigue, and Compassion Fatigue

Burnout Empathy Fatigue Compassion Fatigue

Emotional and physical fatigue Emotional fatigue Emotional exhaustion

Many tasks, deadlines Many distressful encounters One acute traumatic event

Extended period of time Extended period of time One specific moment in time

Cumulative Cumulative Acute

Unspecific source Unspecific source One specific traumatic event

Direct impact to the caregiver Direct impact to the caregiver Secondary impact to the

caregiver – vicarious trauma

Burnout is too much to do, too little time, insufficient resources, lack of validation, unrealistic expectations, and cumulative physical and emotional distress.

Typical causes Tasks Deadlines Expectations

Typical reactions and symptoms Emotional and physical exhaustion Depersonalization Reduced vocational productivity Reduced personal accomplishment Lack of confidence or self-esteem Changes in beliefs, values, and view of workplace or world

Self-care for burnout

Delegate Negotiate Redefine success Set personal boundaries Create margin Make changes in your life Others???

A.4

Dr. Naomi Paget CrisisPlumbline, 2013 [email protected]


Empathy fatigue is emotional and physical fatigue resulting from empathizing with other people’s pain, grief, anxiety, anger, and other strong emotions over an extended period of time.

Typical causes

Non-compartmentalized compassionate care

“Owning” other people’s problems/issues/concerns

Over identifying with other people’s distress

Typical reactions and symptoms

Emotional exhaustion Over-personalization Reduced compassionate attitude Reduced personal ministry satisfaction Lack of ministry confidence or self-esteem Changes in beliefs, values, and view of workplace or world

Self-care for empathy fatigue

Systematic, strategic, intentional breaks, rest, restoration periods

Set personal boundaries

Redefine ministry expectations

Compassion fatigue is the costly result of providing care to those suffering from the consequences of traumatic events. Caregivers are especially vulnerable to compassion fatigue.

Typical causes Empathic connection to trauma survivor Secondary traumatization from experiencing the traumatic

event as though it was a personal experience Typical reactions and symptoms

Secondary traumatic stress symptoms Intrusive memories Avoidance or distancing Stress arousal

Physical symptoms Exhaustion Insomnia Headaches Increased susceptibility to illness

Personal stress management Catharsis Self-awareness Clarifying options Reframing circumstances or situations Intercession Relaxation techniques Pastoral counsel, therapeutic intervention

A.5



What to Do if Someone You’re With Is Talking About Suicide

The First Thing to Talk About With a Suicidal Person

The first and most important reason to talk to a suicidal person is to determine if his or her life is in immediate danger. For example, you might ask: • Are you thinking of taking your life right now? • Have you put a suicide plan into action (such as ingesting alcohol or drugs)? If there is immediate threat to the suicidal person's life or anyone else's, you must call 9-1-1 immediately. Emergency responders are there to save any life that is at risk. You cannot handle a situation like that alone.

The First Thing To Do When Someone is Suicidal

The first thing you need to do if you know someone is suicidal is to assess the situation. If there is any immediate danger to the suicidal person or anyone else call 9-1-1 immediately or take the person to a hospital emergency room. The suicidal person might initially be angry with you for involving emergency responders but remember, it's much better that they be mad at you then they not be there at all.

What Else To Do If Someone is Suicidal

When you're talking to a suicidal person you want to be calm and make the person at ease as much as possible. Even if you find talking about suicide very difficult, its best not to act shocked when a person tries to talk to you about it. What you need to remember is that the suicidal person is reaching out and that is the first step anyone can take to getting better.

There are many things you can do if someone is suicidal. The National Suicide Prevention Lifeline lists these dos and don'ts when helping a suicidal person: Do: • Be direct. Talk openly and matter-of-factly about suicide. • Be willing to listen. Allow expression of feelings. Accept the feelings. • Be non-judgmental. Don't debate whether suicide is right or wrong, or whether feelings

are good or bad. Don't lecture on the value of life. • Get involved. Be available. Show interest and support. Tell the person he or she is not alone. Tell

the person you care about him or her. • Offer hope that alternatives are available but do not offer glib reassurance. • Take action. Facilitate the removal of means, such as guns or stockpiled pills. • Get help from persons or agencies specializing in crisis intervention and suicide prevention. • Encourage him or her strongly to call the Lifeline.

Lifeline operators help suicidal people feel better every day. (1-800-273-8255) Don't: • Dare the person to do it. • Act shocked. This puts distance between the two of you. • Be sworn to secrecy. Always seek help and support.

A.6



How to Talk About Suicide In addition to the above tips, remember that speaking openly and honestly about suicide will not increase the likelihood of suicide and, in fact, often helps. Try to avoid judgmental language and use the term, "die by suicide," if possible (rather than "commit suicide"). Do no glorify suicide nor dwell significantly on suicide methods. (For example, asking a person how they might kill his or herself is fine, but describing a suicide method in detail is not necessary helpful.)

Talk about a suicidal person's feelings with open-ended questions. Some examples include: • When did you begin feeling like this? • Did something happen that made you start feeling this way? • How can I best support you right now? • Have you thought about getting help?

Helpful things to say to a person who is suicidal include: • You are not alone in this. I'm here for you. • You may not believe it now, but the way you're feeling will change. • I may not be able to understand exactly how you feel, but I care about you and want to help. • When you want to give up, tell yourself you will hold off for just one more day, hour, minute – whatever

you can manage.

Where to Get Help for Suicidal People You cannot deal with a suicidal person alone – you must reach out and find help and support,

both for you and for the person who is suicidal.

You can learn where to get help for a suicidal person by calling Lifeline. Lifeline calls are routed to local areas and the operators can tell you about nearby resources like crisis or treatment centers. • National Suicide Prevention Lifeline (available 24/7): 1-800-273-TALK (8255)

http://www.suicidepreventionlifeline.org/ • If you are outside the United States, visit suicide.org or IASP to get a helpline within your locality. • If you're not in the United States, go to Befrienders Worldwide for international information.

http://www.befrienders.org/

Other numbers that may be able to help a person considering suicide include:

The Trevor Project line (for LGBTQ youth): 1-866-488-7386 http://www.thetrevorproject.org/ • United States Veterans Crisis Line: 1-800-273-8255 (press 1) http://www.veteranscrisisline.net/ • stopasuicide.org provides people with warning signs of suicide so you can help prevent others from

such an act • suicidepreventionlifeline.org allows people to call or chat online with a suicide prevention counselor

Additionally, you can do an online search for mental health services thought the American Mental Health Services Locator. http://store.samhsa.gov/mhlocator

Remember This When Helping a Suicidal Person Always remember that while suicide really may seem like the best option to a person in a crisis, there are many other options out there to help the suicidal person choose life. There is always another way

A.7

A.7


http://www.suicidepreventionlifeline.org/

http://www.befrienders.org/

http://www.thetrevorproject.org/

http://www.veteranscrisisline.net/

http://store.samhsa.gov/mhlocator


Disaster Chaplain’s End-of-Day Defusing with Pastoral Care Team

What you will be doing each evening is more correctly called a “defusing,” not a “debriefing.”

Debriefings are conducted 1-10 days afterwards and usually symptom driven. With that being

said, let me share a few things.

The goals of defusing each evening:

Rapid reduction in any intense reactions to the “work”

“Normalizing” of the experience so people can go back out the next day

Re-establishment of the social network so no one on the team becomes isolated

Assessment of the team to determine if anyone is in “crisis” and needs further help

You will also be trying to accomplish these things:

Equalization of information available

Restoration of cognitive processes that have been disrupted

Provision of practical self-care information

Affirmation of individual team member’s value

Establish links for more support

Establish an expectancy for recovery

Doing the defusing each night will probably eliminate the need for a full-blown critical

incident stress debriefing after you return home

Remembering that people must not be forced to speak and that the speaking must be

conversational, not investigative, make gentle efforts to involve everyone in the group to share.

Here are some guidelines for questions to facilitate the discussions and sharing:

Begin by asking the group to tell the team what happened

Ask clarifying questions about their role during the day

Ask for details or about their interactions with people

Sometimes the group may discuss signs of distress being experienced

Usually, the group does a good job of keeping the conversation going

When the conversation begins to lag or when side topics become more important, begin to

close the session. This entire process should take 20-30 minutes.

An important part of this process is to close appropriately

Accept and summarize the information

Answer any questions

Normalize the experience and reactions of the group

Teach practical stress survival skill

Make yourself available afterwards

If you notice that anyone is having extreme stress symptoms, use your mental health

person (your psychologist, therapist, etc.) to help out on a one-to-one basis.

A.8



SPIRITUAL CARE INTERVENTIONS

ASSESSMENT (evaluate mental/behavioral status)

Assess medical/physical/environmental needs

Assess mental/behavioral status

Status of prescription medication, if any

Assess for impairment

Assess degree of impairment

Threat to self / others?

General ability to function

Physical

Tachycardia / Hyperventilation

Muscle spasms / Indigestion

Rule out:

Chest pain,

Persistent irregular heart beats

Seizure, persistent vertigo

Blood in vomit, urine, stool, sputum

Collapse/exhaustion

Cognitive

Orientation (person, place, time)

Presence of cause & effect thinking

Rule out:

Hallucinations / Obsessions

Delusion (paranoia, grandeur)

Violent/homicidal/suicidal thoughts

Dissociation / Disabling guilt

Psychogenic amnesia

Helpless/hopelessness

Behavioral

Impulsiveness

Sleep disturbance

Hypervigilance

Rule out:

Violent acts / Self-medication

Antisocial acts / 1000 yard stare

Interpersonal abuse

Emotional

Acute anxiety

Acute depression

Anger

Fear, phobia, phobic avoidance

Rule out:

Panic attacks

Immobilizing

emotions

Regressive emotions in adults PTSD

Spiritual/Religious

Crisis of Faith

Obsessive Thoughts

Compulsive Acts

PSYCHOLOGICAL INTERVENTION

(use of basic, generic psychological

principles to mitigate crisis)

Cathartic ventilation

Social support / Information

Stress management (e.g. breathing)

Advocacy

Problem solving / Cognitive reframing

LIAISON/ADVOCACY INTERVENTION

(serve as intermediary, advocate)

Facilitation of communications

Psychological buffering, insulation

Advocacy

Helping where needed

SPIRITUAL INTERVENTIONS

(use of pastoral interventions generically

applicable across religions/faiths)

Unique ethos of pastoral care person

Ministry of presence Unique communication


Individual and/or conjoint prayer

Belief in divine order or divine intervention

RELIGIOUS INTERVENTION

(Use of pastoral interventions based upon

specific religious doctrine/belief/scripture)

Scriptural education, insight, interpretation

Rituals, sacraments Rituals of forgiveness, atonement

A.9



Some Essential Principles for Disaster Relief Chaplains

Training for disaster relief chaplains is built on previous training, education,

and experience

There is a significant difference between church pastor and community

pastoral caregiver

In disaster relief, church pastors and laity must function in the role of

“chaplain”

Disaster relief chaplains are “spiritual paramedics”

Understanding the hierarchy of needs help identify the perceived crisis need

There are age specific responses to crisis

Spiritual caregivers must learn recognize the signs of trauma

Listening to the story is as important as telling The Story

“Perception” of the event influences the reactions to trauma

“Perception” of the pastoral care influences the effectiveness of the ministry

Chaplain ministry includes the ministry of presence, compassion, silence,

listening, and advocacy

Observing the rules of chain-of-command help disaster teams function

effectively in chaos

Victims may experience perceived losses that others do not recognize

Disaster relief chaplains must be part of a recognized crisis intervention team

Spiritual caregivers must never “self-deploy” to a disaster scene

The ministry of disaster relief chaplain is an intentional choice to be in a place

of suffering

Compassion fatigue is common among disaster relief chaplains

Self-care happens before, during, and after the disaster intervention

Cultural diversity influences people’s reactions to crisis

Pastoral caregivers demonstrate respect for cultural differences by

demonstrating cultural competence

Ministry in diversity is not a call to abandon or violate one’s personal faith

Critical events redefine one’s spirituality

Victims and survivors ask difficult questions Disaster relief chaplains must struggle with the victims as they ask their

questions. . . not answer them


A.10


Tips for a Meaningful Deployment

1. You will have a specific duty assignment. Stay engaged in your assignment until your

Supervisor reassigns you. Your team depends on you to complete your assignment.

2. You may have many skills in many areas. We are grateful for all those skills. Use the skills

you have appropriately in your assigned duties.

3. We honor the vulnerability of the victims, survivors, and others who have been impacted by

disasters.

a. Please be sensitive in your language and behavior if you engage with any of them.

We are respectful by not using profanity, making empty promises, or asking probing

questions about sensitive matters.

b. Please respect the privacy of those we serve by maintaining a respectful physical

distance when talking and listening. Hugs may be unwanted or threatening to some

people. Taking photos is usually inappropriate and invasive – ask your Supervisor

first.

c. Prayer is a meaningful and regular part of our lives. Most people welcome kind and

sensitive prayer. We always ask permission to pray, knowing that it might not be a

welcome spiritual intervention. Ask the client what he/she would like you to pray

about. Prayers should be short, specific, and spontaneous.

d. Women and children are especially vulnerable during disasters and crises. We

protect them and ourselves from misunderstandings and public scrutiny by allowing

our female chaplains to engage with them. When men engage with women or

children, we require at least the company of two people during the conversation or

engagement whenever possible.

4. We are sensitive to the diversity we serve. Remember to provide ministry services in a

respectful and appropriate way.

5. We treat everyone with respect and dignity, never prioritizing one person because of race,

religion, or political preference. The principle of universality is essential in supportive services.

6. We do not engage in controversial issues. We remain neutral to politics, and other divisive

issues.

7. Our mission is to support those who have been impacted by disasters and other crises.

Therefore, we do not intend to personally gain in any way by our service, ministry, or

compassionate care.


A.11


NATIONAL VOLUNTARY ORGANIZATIONS ACTIVE IN DISASTER (NVOAD) POINTS OF CONSENSUS

DISASTER SPIRITUAL CARE

In 2006 the National Voluntary Organizations Active in Disaster’s Emotional and Spiritual Care Committee published Light Our Way to inform, encourage and affirm those who respond to disasters and to encourage standards insuring those affected by disaster receive appropriate and respectful spiritual care services. As a natural next step following the publication of Light Our Way and in the spirit of the NVOAD “Four C’s” (cooperation, communication, coordination and collaboration), the Emotional and Spiritual Care Committee then began working to define more specific standards for disaster spiritual care providers. The following ten “points of consensus” set a foundation for that continuing work.

1. Basic concepts of disaster spiritual care1

Spirituality is an essential part of humanity. Disaster significantly disrupts people’s spiritual lives. Nurturing people’s spiritual needs contributes to holistic healing. Every person can benefit from spiritual care in time of disaster.

2. Types of disaster spiritual care2

Spiritual care in disaster includes many kinds of caring gestures. Spiritual care providers are from diverse backgrounds. Adherence to common standards and principles in spiritual care ensures that this service is delivered and received appropriately.

3. Local community resources As an integral part of the pre-disaster community, local spiritual care providers and communities of

faith are primary resources for post-disaster spiritual care. Because local communities of faith are uniquely equipped to provide healing care, any spiritual care services entering from outside of the community support but do not substitute for local efforts. The principles of the National VOAD - cooperation, coordination, communication and collaboration - are essential to the delivery of disaster spiritual care.

4. Disaster emotional care and its relationship to disaster spiritual care3

Spiritual care providers partner with mental health professionals in caring for communities in disaster. Spiritual and emotional care share some similarities but are distinct healing modalities. Spiritual care providers can be an important asset in referring individuals to receive care for their mental health and vice versa.

5. Disaster spiritual care in response and recovery4

Spiritual care has an important role in all phases of a disaster, including short-term response through long-term recovery. Assessing and providing for the spiritual needs of individuals, families, and communities can kindle important capacities of hope and resilience. Specific strategies for spiritual care during the various phases can bolster these strengths.

6. Disaster emotional and spiritual care for the care giver Providing spiritual care in disaster can be an overwhelming experience. The burdens of caring for others in this context can lead to compassion fatigue. Understanding important strategies for self-care is essential for spiritual care providers. Disaster response agencies have a responsibility to model

healthy work and life habits to care for their own staff in time of disaster.5 Post-care processes for spiritual and emotional care providers are essential.

A.12


7. Planning, preparedness, training and mitigation as spiritual care components6

Faith community leaders have an important role in planning and mitigation efforts. By preparing their congregations and themselves for disaster they contribute toward building resilient communities. Training for the role of disaster spiritual care provider is essential before disaster strikes.

8. Disaster spiritual care in diversity Respect is foundational to disaster spiritual care. Spiritual care providers demonstrate respect for

diverse cultural and religious values by recognizing the right of each faith group and individual to hold to their existing values and traditions. Spiritual care providers:

• Refrain from manipulation, disrespect or exploitation of those impacted by disaster and trauma.

• Respect the freedom from unwanted gifts of religious literature or symbols, evangelistic and sermonizing speech, and/or forced acceptance of specific moral values and traditions.7

• Respect diversity and differences, including but not limited to culture, gender, age, sexual orientation, spiritual/religious practices and disability.

9. Disaster, trauma and vulnerability People impacted by disaster and trauma are vulnerable. There is an imbalance of power between

disaster responders and those receiving care. To avoid exploiting that imbalance, spiritual care providers refrain from using their position, influence, knowledge or professional affiliation for unfair advantage or for personal, organizational or agency gain.

Disaster response will not be used to further a particular political or religious perspective or cause – response will be carried out according to the need of individuals, families and communities. The promise, delivery, or distribution of assistance will not be tied to the embracing or acceptance of a particular political or religious creed. 8

10. Ethics and Standards of Care NVOAD members affirm the importance of cooperative standards of care and agreed ethics.

Adherence to common standards and principles in spiritual care ensures that this service is delivered and received appropriately. Minimally, any guidelines developed for spiritual care in times of disaster should clearly articulate the above consensus points in addition to the following:

• Standards for personal and professional integrity

• Accountability structures regarding the behavior of individuals and groups

• Concern for honoring confidentiality*

• Description of professional boundaries that guarantee safety of clients* including standards regarding interaction with children, youth and vulnerable adults

• Policies regarding criminal background checks for service providers

• Mechanisms for ensuring that caregivers function at levels appropriate to their training and educational backgrounds*

• Strong adherence to standards rejecting violence against particular groups

• Policies when encountering persons needing referral to other agencies or services

• Guidelines regarding financial remuneration for services provided

Ratified by Full Membership, 2009

1 See Light Our Way pp. 52-54. 2 Ibid. 3 Ibid. 4 Ibid. 5 Ibid. 6 Ibid. 7 Church World Service “Standard of Care for Disaster Spiritual Care Ministries” 8 Church World Service “Common Standards and Principles for Disaster Response” *See Light Our Way p. 16

A.13

Documents

Southern Baptist Disaster Relief · 2019. 5. 23. · In parallel development, the American Red Cross formally began deploying the Spiritual Care Aviation Incident Response Team (now